Healthcare Provider Details

I. General information

NPI: 1336105287
Provider Name (Legal Business Name): NANNETTE L. VOWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1662 HIGDON FERRY ROAD SUITE 100
HOT SPRINGS AR
71913
US

IV. Provider business mailing address

PO BOX 21908
HOT SPRINGS AR
71903-1908
US

V. Phone/Fax

Practice location:
  • Phone: 501-520-5476
  • Fax: 501-520-5486
Mailing address:
  • Phone: 501-520-5476
  • Fax: 501-520-5486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE4414
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: