Organization
JOHN H NICHOLSON DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H NICHOLSON DO (PRES)
(610) 826-5805
Entity
Organization
Contact information
Practice address
169 DELAWARE AVE, PALMERTON, PA 18071-1708
(610) 826-5805
Mailing address
169 DELAWARE AVE, PALMERTON, PA 18071-1708
(610) 826-5805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS003895L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03217900
CAPITAL BLUE CROSS
PA
Enumeration date
07/22/2006
Last updated
08/22/2020
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