Organization
SHOALS ORTHOPEDICS AND SPORTS MEDICINE
Active
Other names
SHOALS ORTHOPEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
LEE NICHOLS JR. MD (PRESIDENT)
(256) 718-4041
Entity
Organization
Contact information
Practice address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Mailing address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4562760001
MEDCIARE DMERC
AL
05
—
529911910
—
AL
Enumeration date
08/17/2012
Last updated
08/17/2012
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