Provider Demographics
NPI:1336105287
Name:VOWELL, NANNETTE L (MD)
Entity Type:Individual
Prefix:DR
First Name:NANNETTE
Middle Name:L
Last Name:VOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21908
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1908
Mailing Address - Country:US
Mailing Address - Phone:501-520-5476
Mailing Address - Fax:501-520-5486
Practice Address - Street 1:1662 HIGDON FERRY ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-520-5476
Practice Address - Fax:501-520-5486
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4414207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5N4687470Medicare PIN
5N468F484Medicare PIN
G02727Medicare UPIN
P00309182Medicare PIN