Provider Demographics
NPI:1912019878
Name:WILLIAM H.NEVINS,M.D.,P.A
Entity Type:Organization
Organization Name:WILLIAM H.NEVINS,M.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-268-2201
Mailing Address - Street 1:102 E PLEASURE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7710
Mailing Address - Country:US
Mailing Address - Phone:501-268-2201
Mailing Address - Fax:501-268-0208
Practice Address - Street 1:102 E PLEASURE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7710
Practice Address - Country:US
Practice Address - Phone:501-268-2201
Practice Address - Fax:501-268-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4161207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104691002Medicaid
AR104691002Medicaid
AR57335Medicare ID - Type Unspecified