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Individual

LUKE O NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

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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