| J. W Nuckolls Md | |
|
1801 W 40th Ave Suite 1c Pine Bluff AR 71603-6956 | |
| (870) 541-0222 | |
| (870) 541-0315 |
| Full Name | J. W Nuckolls Md |
|---|---|
| Speciality | Clinic/center |
| Location | 1801 W 40th Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | J. W Nuckolls (OWNER) |
| Authorized Official Contact | 8705410222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. W Nuckolls Md 1801 West 40th Suite 1-c Pine Bluff AR 71603-6956 Ph: (870) 541-0222 | J. W Nuckolls Md 1801 W 40th Ave Suite 1c Pine Bluff AR 71603-6956 Ph: (870) 541-0222 |
| NPI Number | 1750345575 |
|---|---|
| Provider Enumeration Date | 04/17/2006 |
| Last Update Date | 10/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750345575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | R2177 (Arkansas) | Primary |
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