Provider Demographics
NPI:1740738640
Name:KENT P NACHTIGAL, MD, PA
Entity Type:Organization
Organization Name:KENT P NACHTIGAL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:P
Authorized Official - Last Name:NACHTIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-701-5051
Mailing Address - Street 1:PO BOX 1893
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654-1893
Mailing Address - Country:US
Mailing Address - Phone:870-701-5051
Mailing Address - Fax:870-701-5076
Practice Address - Street 1:230 HIGHWAY 5 N
Practice Address - Street 2:SUITE 10
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3027
Practice Address - Country:US
Practice Address - Phone:870-701-5051
Practice Address - Fax:870-701-5076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty