Provider Demographics
NPI:1366612566
Name:ARNOTT, ANTHONY TODD (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TODD
Last Name:ARNOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-7241
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:1029 YORK ST NE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-4025
Practice Address - Country:US
Practice Address - Phone:803-648-4119
Practice Address - Fax:706-774-7230
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA61821207Q00000X, 207Q00000X
SC37906207Q00000X
KYTP779207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3159059Medicaid
WV3810020151Medicaid
KY7100164720Medicaid
AL102I084194OtherMEDICARE
GAPENDINGMedicare UPIN
AL102I084194OtherMEDICARE