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Organization
SHOALS ORTHOPEDICS AND SPORTS MEDICINE
Active
Organization
SHOALS ORTHOPEDICS AND SPORTS MEDICINE
Active
Other names
SHOALS ORTHOPEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
LEE NICHOLS JR. MD (PRESIDENT)
(256) 718-4041
Entity
Organization
Contact information
Practice address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Mailing address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4562760001
MEDCIARE DMERC
AL
05
—
529911910
—
AL
Enumeration date
08/17/2012
Last updated
08/17/2012
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