Basic Information
| Provider Information | |||||||||
| NPI: | 1003009218 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOLEN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | MORRILTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721104510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013544637 | ||||||||
| FaxNumber: | 5015525326 | ||||||||
| Practice Location | |||||||||
| Address1: | 1711 E HARDING ST | ||||||||
| Address2: | |||||||||
| City: | MORRILTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721104507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013544637 | ||||||||
| FaxNumber: | 5015525326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 01/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C5434 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 104951001 | 05 | AR | MEDICAID |