Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 7890 | KY |
Y | 1223G0001X | General Practice | 7890 | KY |
Y | 213EG0000X | General Practice | 7890 | KY |
NPI | 1134271919 |
---|---|
Provider Name | Dr. Kelly A Arnold |
First Address | Lexington, KY 40517-4285 |
Second Address | Lexington, KY 40517-4285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 11/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60001708 | (05) | KY |