Individual
DR. WILLIS TYLER NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1711 N MCKENZIE ST STE 201, FOLEY, AL 36535-2282
(251) 424-1620
(251) 952-6620
Mailing address
1711 N MCKENZIE ST STE 201, FOLEY, AL 36535-2282
(251) 949-3479
(251) 949-3434
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34161
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00187592
—
MS
05
—
105926100
—
FL
05
—
211911
—
AL
05
—
214769
—
AL
Enumeration date
10/15/2010
Last updated
10/14/2025
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