# JOHN H NICHOLSON DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235150384
- **Authorized official:** DR. JOHN H NICHOLSON DO (PRES)
- **Authorized official phone:** (610) 826-5805

## Contact information

- **Practice address:** 169 DELAWARE AVE, PALMERTON, PA 18071-1708
- **Practice address phone:** (610) 826-5805
- **Mailing address:** 169 DELAWARE AVE, PALMERTON, PA 18071-1708
- **Mailing address phone:** (610) 826-5805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS003895L | PA | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 03217900 | CAPITAL BLUE CROSS | PA |