Individual
MR. JERRY RANDALL NUTT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
515 CASH RD SW, CAMDEN, AR 71701-3706
(870) 836-2525
(870) 836-7252
Mailing address
515 CASH RD SW, CAMDEN, AR 71701-3706
(870) 836-2525
(870) 836-7252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2570
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180852722
—
AR
01
—
49958
ARK BCBS
AR
Enumeration date
09/28/2006
Last updated
05/10/2011
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