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Individual
DR. JEROME TAK NICHOLS
Active
Individual
DR. JEROME TAK NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
070145
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101261482
VA
208100000X
Physical Medicine & Rehabilitation Physician
TP934
KY
Other
Enumeration date
07/06/2007
Last updated
04/13/2023
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