Individual
SCOTT NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1 S BRYANT AVE, EDMOND, OK 73034-6309
(405) 341-6100
Mailing address
7477 E 46TH PL, TULSA, OK 74145-6305
(918) 384-0002
(918) 384-0004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2676
OK
363AM0700X
Medical Physician Assistant
Primary
2676
OK
Other
Enumeration date
07/19/2016
Last updated
03/17/2020
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