Provider Demographics
NPI:1700235280
Name:WINSLOW, NOLAN (MD)
Entity type:Individual
Prefix:
First Name:NOLAN
Middle Name:
Last Name:WINSLOW
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:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:479-338-3720
Mailing Address - Fax:479-338-3749
Practice Address - Street 1:2708 S RIFE MEDICAL LN STE 140
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1455
Practice Address - Country:US
Practice Address - Phone:479-338-3720
Practice Address - Fax:479-338-3749
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.068677207T00000X
ARE-18933207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery