J. W Nuckolls MD
NPI #1750345575 in Pine Bluff, Arkansas
Provider Information
- NPI Number
- 1750345575
- Entity Type
- Organization
- Organization Name
- J. W Nuckolls MD
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Apr 17, 2006
- Last Updated
- Oct 26, 2007
Practice Location
- Address
- 1801 W 40TH AVE
- Address 2
- SUITE 1C
- City
- Pine Bluff
- State
- Arkansas
- ZIP Code
- 71603-6956
- Phone
- (870) 541-0222
Authorized Official
- Name
- DR. J. W NUCKOLLS, M.D.
- Title
- OWNER
- Phone
- (870) 541-0222
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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