J. W Nuckolls MD

J. W Nuckolls MD is a healthcare organization registered as Clinic/Center in Pine Bluff, AR, holding Type 2 (organization) NPI 1750345575 since 2006. The authorized official on file is J. Nuckolls, Owner.

✓ Active NPI ✓ Valid NPI checksum

NPI	1750345575
Entity type	Organization (Type 2)
Legal business name	J. W Nuckolls MD
Practice address	1801 W 40TH AVE, SUITE 1C, Pine Bluff, AR, 71603
Phone	8705410222
Fax	8705410315
Enumeration date	2006-04-17
Last updated in NPPES	2007-10-26

Authorized official

Name	J. Nuckolls
Title	Owner
Phone	8705410222

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261Q00000X	Clinic/Center	Primary	R2177	AR

Copy-ready billing details

Provider: J. W Nuckolls MD
NPI: 1750345575
Taxonomy: 261Q00000X (Clinic/Center)
Address: 1801 W 40TH AVE, SUITE 1C, Pine Bluff, AR, 71603

Providers at this address

NPI	Name	Type	Specialty	Location
1679577662	Anna Redman	Individual	Family Medicine Physician	Pine Bluff, AR
1245234061	Nancy Williams	Individual	Family Medicine Physician	Pine Bluff, AR
1053316067	Fawad Walajahi	Individual	Anesthesiology Physician	Pine Bluff, AR
1497750418	Jeffrey Bryles	Individual	Anesthesiology Physician	Pine Bluff, AR
1407851439	Lori Cole	Individual	Certified Registered Nurse Anesthetist	Pine Bluff, AR
1306841358	Jon Valentine	Individual	Certified Registered Nurse Anesthetist	Pine Bluff, AR
1356346316	Walter Theriot	Individual	Certified Registered Nurse Anesthetist	Pine Bluff, AR
1174528186	Ferdinand Samuel	Individual	Anesthesiology Physician	Pine Bluff, AR

Verify this record

Cross-check NPI 1750345575 against the authoritative CMS record: view J. W Nuckolls MD on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2007-10-26. Verify at npiregistry.cms.hhs.gov.

Where is J. W Nuckolls MD located?

The practice location on file with NPPES is in Pine Bluff, AR.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-10-26.