Basic Information
| Provider Information | |||||||||
| NPI: | 1942628805 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NUNEZ | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | ANTONIO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 N 3RD ST APT 518 | ||||||||
| Address2: | NONE | ||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729011481 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6466199939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 TOWSON AVE | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729014921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794414000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2014 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | E10462 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.