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Organization

R C NICHOLS JR MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROMAINE C NICHOLS M.D. (MEDICAL DIRECTOR)
(850) 769-0009
Entity
Organization

Contact information

Practice address
615 N BONITA AVE, BAY REGIONAL CANCER CENTER, PANAMA CITY, FL 32401-3623
(850) 747-6972
(850) 747-6584
Mailing address
PO BOX 2506, PANAMA CITY, FL 32402-2506
(850) 769-0009
(850) 769-0070

Taxonomy

Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
ME0056785
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15097
BLUE CROSS OF FLORIDA
FL
Enumeration date
04/14/2008
Last updated
04/15/2008
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