Individual
DR. GEORGE RICHARD NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 N KEENE ST, SUITE 201, COLUMBIA, MO 65201-7193
(573) 876-1000
(573) 442-7899
Mailing address
303 N KEENE ST, SUITE 201, COLUMBIA, MO 65201-7193
(573) 876-1000
(573) 442-7899
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2008016028
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008016028
STATE LICENSE
MO
Enumeration date
04/18/2007
Last updated
03/04/2010
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