J. W Nuckolls, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

R2177 Issued in AR

Practice address

1801 W 40TH Ave
Pine Bluff, AR 71603-6940

Phone

(870) 541-0222

Fax

(870) 541-0315

NPI assigned

Oct 26, 2007

Last updated

Oct 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• J. W Nuckolls MD

  • Clinic/Center
  • Pine Bluff, AR
  • NPI 1750345575
  NPD (past) Authorized official

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1881873826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-541-0222",
            "fax_number": "870-541-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-541-0222",
            "fax_number": "870-541-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCKOLLS",
        "first_name": "J.",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "R2177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa M Nix, LMSW
• David T. Nixon, M.D.
• Robert Benjamin Noble, PA
• Susan Norton
• Farren Norwood, MHPP
• Shakespeare S Nunag, P,T,
• Nutrition Counseling & Consulting LLC
• Carolyn L O'Bryant, RN
• Marian O Obi, MD
• Chinweoke Obiozor, FNP-BC

• Specialist in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.