Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | C5434 | AR |
NPI | 1003009218 |
---|---|
Provider Name | Dr. James E Nolen |
First Address | Morrilton, AR 72110-4510 |
Second Address | Morrilton, AR 72110-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104951001 | (05) | AR |
53860 | (02) | AR |
D04820 | (02) | AR |