Individual
TIMOTHY KENT MCNICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 W INA RD, TUCSON, AZ 85704-1985
(520) 585-5738
(520) 585-5843
Mailing address
4801 E BROADWAY BLVD STE 251, TUCSON, AZ 85711-3633
(520) 327-0460
(520) 795-0225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2000157963
MO
207R00000X
Internal Medicine Physician
Primary
40509
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126895
BLUE CROSS/BLUE SHIELD
—
05
—
205007701
—
MO
Enumeration date
06/07/2006
Last updated
04/07/2026
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