Individual
GRAIG L NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 SCHWEGLER DRIVE, KU SHS - WATKINS MEMORIAL HEALTH CENTER, LINDSBORG, KS 66045
(785) 864-9500
Mailing address
3916 PRAIRIE ROSE ST, LAWRENCE, KS 66049-7825
(785) 856-0025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-28982
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100409080B
—
KS
Enumeration date
07/13/2006
Last updated
12/27/2013
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