# JOHN C. NICHOLSON, MD

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

## Provider details

- **NPI number:** 1639208903
- **Authorized official:** JOHN C NICHOLSON M.D. (PHYSICIAN OWNER)
- **Authorized official phone:** (802) 524-4554

## Contact information

- **Practice address:** 2 CREST RD, SAINT ALBANS, VT 05478-9753
- **Practice address phone:** (802) 524-4554
- **Practice address fax:** (802) 524-3216
- **Mailing address:** PO BOX 1363, WILLISTON, VT 05495-1363
- **Mailing address phone:** (802) 524-7100
- **Mailing address fax:** (802) 524-7021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0420010190 | VT | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0VN2606 | — | VT |