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General NPI Number Information
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NPI Number | 1063683605
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Entity Type | Organization
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Legal Business Name | ARKANSAS DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 611 E WASHINGTON AVE SUITE B
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City | JONESBORO
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State | AR
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Zip | 72401-3070
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Country | US
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Telephone | 870-933-6247
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Fax |
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Provider Business Mailing Address
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Address Line | 4815 W MARKHAM ST SLOT H 16
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BRANCH CHIEF
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Name | DR. RICHARD R NUGENT
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Credential | M.D., MPH
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Telephone | 501-661-2086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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