J. W NUCKOLLS MD
NPI 1750345575
Clinic/Center in Pine Bluff, AR

Q: What is J. W Nuckolls MD's NPI number?

The NPI number for J. W Nuckolls MD is 1750345575. It was assigned to this organization in the NPPES registry on April 17, 2006.

Q: What is J. W Nuckolls MD's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Q: When was this NPI record last updated?

The NPPES record for J. W Nuckolls MD was last updated on October 26, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 17, 2006

1801 W 40TH AVE, SUITE 1C, PINE BLUFF, AR 71603(870) 541-0222(870) 541-0315 Get Directions Write a Review

NPPES record last updated: October 26, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About J. W Nuckolls Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

J. W NUCKOLLS MD (NPI 1750345575) is a healthcare organization registered as a clinic/center in Pine Bluff, Arkansas and active in the NPI registry since April 2006. The organization lists J. W Nuckolls, Owner, as its authorized official.

NPPES Registry Identity

NPI1750345575

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameJ. W NUCKOLLS MD

Location Address1801 W 40TH AVE, SUITE 1CPine Bluff, AR 71603-6956

Mailing Address1801 West 40th, Suite 1-cPine Bluff, AR 71603-6956 · (870) 541-0222 · Fax (870) 541-0315

Phone(870) 541-0222

Fax(870) 541-0315

Organization SubpartNo

Authorized OfficialJ. W NuckollsOwner · (870) 541-0222

Enumeration DateApril 17, 2006

Last NPPES UpdateOctober 26, 2007

✔ NPI 1750345575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in AR · R2177

Definition

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).

1801 W 40TH AVE, Pine Bluff, AR 71603

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Other Identifiers 2

Medicare UPINE05073AR

Medicare ID-Type Unspecified53847AR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAWAD H WALAJAHI M.D.

Anesthesiology