# THOMAS D NICHOLAS MD DANIEL J DWYER MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rockville Town Square Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770706400
- **Authorized official:** DANIEL J DWYER MD (PARTNER)
- **Authorized official phone:** (765) 569-2057

## Contact information

- **Practice address:** 111 W HIGH ST, ROCKVILLE, IN 47872
- **Practice address phone:** (765) 569-2057
- **Practice address fax:** (765) 569-2340
- **Mailing address:** 111 W HIGH ST, ROCKVILLE, IN 47872
- **Mailing address phone:** (765) 569-2057
- **Mailing address fax:** (765) 569-2340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 15D0362127 | NULL | Yes |
| 208D00000X | General Practice Physician | 15D0362127 | — | Yes |

## Other

- **Enumeration date:** 04/11/2007
- **Last updated:** 07/24/2008