Alfred Walter Nutt, PH.D., M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

27882 Issued in GA

Practice address

4275 Owens Rd Apt 125
Evans, GA 30809-3064

Phone

(706) 513-3921

NPI assigned

Feb 1, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Alfred Walter Nutt Jr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1841539566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 OWENS RD APT 125",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093064",
            "telephone_number": "706-513-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 OWENS RD APT 125",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093064",
            "telephone_number": "706-513-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "ALFRED",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-01",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "27882",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "12575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALFRED",
            "last_name": "NUTT",
            "middle_name": "WALTER",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "PH.D., M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Physician in Evans, GA
• Providers in Evans, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.