Individual
DR. ROBERT KENNETH NICHOLS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 E MAIN ST, PRATTVILLE, AL 36067-3114
(334) 361-0986
(334) 361-1134
Mailing address
120 E MAIN ST, PRATTVILLE, AL 36067-3114
(334) 361-0986
(334) 361-1134
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12055
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C73810
UPNUMBER
AL
Enumeration date
01/18/2007
Last updated
09/02/2014
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