Organization
J. W NUCKOLLS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. W NUCKOLLS M.D. (OWNER)
(870) 541-0222
Entity
Organization
Contact information
Practice address
1801 W 40TH AVE, SUITE 1C, PINE BLUFF, AR 71603-6956
(870) 541-0222
(870) 541-0315
Mailing address
1801 WEST 40TH, SUITE 1-C, PINE BLUFF, AR 71603-6956
(870) 541-0222
(870) 541-0315
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
R2177
AR
Other
Enumeration date
04/17/2006
Last updated
10/26/2007
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