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Organization
KEITH A NICHOLS MD, PLLC
Active
Organization
KEITH A NICHOLS MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE E NICHOLS (BUSINESS MANAGER)
(607) 687-5616
Entity
Organization
Contact information
Practice address
130 TEMPLE ST, SUITE 100, OWEGO, NY 13827-1408
(607) 687-5616
Mailing address
130 TEMPLE ST, SUITE 100, OWEGO, NY 13827-1408
(607) 687-5616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
141416-1
NY
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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