Provider Demographics
NPI:1871914911
Name:MICHAEL T. NOLEN, M. D., P. A.
Entity type:Organization
Organization Name:MICHAEL T. NOLEN, M. D., P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-492-2525
Mailing Address - Street 1:7 SHACKLEFORD WEST BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3886
Mailing Address - Country:US
Mailing Address - Phone:501-492-2525
Mailing Address - Fax:
Practice Address - Street 1:7 SHACKLEFORD WEST BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3886
Practice Address - Country:US
Practice Address - Phone:501-492-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty