Provider Demographics
NPI:1043230964
Name:TUGWELL, NOEL C (MPT, MS)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:C
Last Name:TUGWELL
Suffix:
Gender:M
Credentials:MPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 WESTPARK DR
Mailing Address - Street 2:STE 6
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4283
Mailing Address - Country:US
Mailing Address - Phone:479-250-4014
Mailing Address - Fax:479-250-4015
Practice Address - Street 1:1002 WESTPARK DR
Practice Address - Street 2:STE 6
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4283
Practice Address - Country:US
Practice Address - Phone:479-250-4014
Practice Address - Fax:479-250-4015
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y171OtherBCBS PROVIDER NUMBER