J. W NUCKOLLS MD (NPI# 1750345575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750345575 |
| Entity Type | Organization |
| Organization Name | J. W NUCKOLLS MD |
| Practice Address |
1801 W 40th Ave Suite 1c Pine Bluff AR 71603-6956 |
| Mailing Address |
1801 West 40th Suite 1-c Pine Bluff AR 71603-6956 |
| Practice Telephone | 8705410222 |
| Practice Fax Number | 8705410315 |
| Mailing Telephone | 8705410222 |
| Mailing Fax Number | 8705410315 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2007-10-26 |
| Authorized Official Name | DR. J. W NUCKOLLS (OWNER) |
| Authorized Official Telephone | 8705410222 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | R2177 | AR | Ambulatory Health Care Facilities |
| Street Address |
1801 W 40TH AVE SUITE 1C |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-6956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679577662 | Anna Talley Redman | Family Medicine | 1801 W 40th Ave, Ste 6a, Pine Bluff, AR 71603-6963 | 2005-06-08 |
| 1366822058 | Nicholas Holloway | Nurse Anesthetist, Certified Registered | 1801 W 40th Ave, Suite 2b, Pine Bluff, AR 71603-6940 | 2015-06-08 |
| 1306223078 | Clay Young | Registered Nurse | 1801 W 40th Ave, 2b, Pine Bluff, AR 71603-6940 | 2015-05-01 |
| 1346534047 | Arkansas Foot & Ankle Clinic, Pa | Podiatrist | 1801 W 40th Ave, Suite 4e, Pine Bluff, AR 71603-6940 | 2011-05-31 |
| 1477886109 | Arkansas Nephrology & Hypertension Clinic Pa | Specialist | 1801 W 40th Ave, Suite 7a, Pine Bluff, AR 71603-6940 | 2009-09-14 |
| 1114151404 | Sarahrose Schneider Webster | Surgery | 1801 W 40th Ave, Suite 4c, Pine Bluff, AR 71603-6940 | 2009-05-14 |
| 1730351941 | Jefferson Hospital Association | Clinic/Center | 1801 W 40th Ave, Suite 4b, Pine Bluff, AR 71603-6940 | 2008-03-27 |
| 1033380308 | John E Harris Md Pa | Family Medicine | 1801 W 40th Ave, Suite 5c, Pine Bluff, AR 71603-6940 | 2008-03-14 |
| 1316125040 | Oberia Lashon Byrd-hunt | Registered Nurse | 1801 W 40th Ave, Suite 2-b, Pine Bluff, AR 71603-6940 | 2008-02-05 |
| 1356525026 | Family Medicine Podiatry | Podiatrist | 1801 W 40th Ave, Suite 6b, Pine Bluff, AR 71603-6940 | 2007-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553555 | Diet of A Lifetime, LLC | Clinic/Center | 123 S Pine St, Pine Bluff, AR 71601-4222 | 2019-05-17 |
| 1134202336 | Walker Healthcare for Women | Clinic/Center | 1305 W 43rd Ave, Pine Bluff, AR 71603-7024 | 2006-10-23 |
| 1841235868 | Jefferson Hospital Association, Inc | Clinic/Center | 4747 Dusty Lake Dr Ste 101, Pine Bluff, AR 71603-9057 | 2006-06-17 |
| 1275599789 | South Arkansas Endocrinology | Clinic/Center | 4747 Dusty Lake Dr Ste G2, Pine Bluff, AR 71603-9056 | 2006-04-24 |
| 1861729311 | V. Bryan Perry Md Pa | Clinic/Center | 1722 W 42nd Ave, Pine Bluff, AR 71603-7008 | 2009-11-04 |
| 1730351941 | Jefferson Hospital Association | Clinic/Center | 1801 W 40th Ave, Suite 4b, Pine Bluff, AR 71603-6940 | 2008-03-27 |
| 1891975173 | Amy Boast Cahill, M.d., P.a. | Clinic/Center | 1609 W 40th Ave, Suite 204, Pine Bluff, AR 71603-6319 | 2007-11-05 |
| 1538286554 | Advanced O&p Techniques | Clinic/Center | 2425 W 28th Ave, Pine Bluff, AR 71603-5051 | 2007-03-23 |
| 1053484782 | Jefferson Hospital Association | Clinic/Center | 1400 Claud Rd, Pine Bluff, AR 71602-8622 | 2006-11-17 |
| 1073549242 | Mike S. Mcfarland Mdpa | Clinic/Center | 3805 W 28th Ave, Pine Bluff, AR 71603-4774 | 2006-06-23 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.