Individual
J. W NUCKOLLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 W 40TH AVE, PINE BLUFF, AR 71603-6940
(870) 541-0222
(870) 541-0315
Mailing address
1801 W 40TH AVE, PINE BLUFF, AR 71603-6940
(870) 541-0222
(870) 541-0315
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R2177
AR
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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