# NICHOLS MED EVAL, LLC

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

## Provider details

- **NPI number:** 1720419450
- **Authorized official:** DR. JAMES THOMAS NICHOLS III MD (MD/SOLE OWNER)
- **Authorized official phone:** (318) 617-6662

## Contact information

- **Practice address:** 136 RIALS DR, MANY, LA 71449-8109
- **Practice address phone:** (318) 575-9911
- **Practice address fax:** (318) 703-5760
- **Mailing address:** PO BOX 5313, SHREVEPORT, LA 71135-5313
- **Mailing address phone:** (318) 798-4664
- **Mailing address fax:** (318) 798-4457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2013
- **Last updated:** 12/10/2013