Individual
JAMES KIM NUCKOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
600 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-5207
(731) 658-1758
Mailing address
222 BARRETT ST, BOLIVAR, TN 38008-1128
(731) 658-6487
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3703
TN
183500000X
Pharmacist
E5645
MS
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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