Organization
RANDALL W. NICHOLS M D , PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALDINE LEWIS (OFFICE MANAGER)
(334) 677-6220
Entity
Organization
Contact information
Practice address
112 HAVEN DR, SUITE 2, DOTHAN, AL 36301-2957
(334) 677-6220
Mailing address
112 HAVEN DR, SUITE 2, DOTHAN, AL 36301-2957
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9258
AL
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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