Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 43386 | TN |
N | 207VX0000X | Obstetrician | 43386 | TN |
NPI | 1215147483 |
---|---|
Provider Name | Kelly Rodney Arnold |
First Address | Chattanooga, TN 37403 |
Second Address | Chattanooga, TN 37403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 16/09/2011 |