Provider Demographics
NPI:1306889407
Name:NUGENT, LOYD E (MD)
Entity type:Individual
Prefix:DR
First Name:LOYD
Middle Name:E
Last Name:NUGENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SE J ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4266
Mailing Address - Country:US
Mailing Address - Phone:479-531-4444
Mailing Address - Fax:
Practice Address - Street 1:2701 SE J ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4266
Practice Address - Country:US
Practice Address - Phone:479-531-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3914207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4521146OtherAETNA
ARR3914OtherARKANSAS STATE LICENSE
ARR3914OtherARKANSAS STATE LICENSE
ARR3914OtherARKANSAS STATE LICENSE
ARB65208Medicare UPIN