Individual
LUKE O NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9211 E 21ST ST N, WICHITA, KS 67206-2968
(316) 609-4400
(316) 634-4040
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27107
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100335940B
—
KS
01
—
101029
BCBS
KS
01
—
102900
HPK
KS
01
—
11984
PHS
KS
01
—
12149442
MULTIPLAN
KS
01
—
81682
COVENTRY
KS
Enumeration date
07/03/2006
Last updated
02/07/2015
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