Individual
DR. JEFFREY TODD NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2401 5TH ST N, SUITE 2, COLUMBUS, MS 39705-2005
(662) 713-1111
(662) 713-1113
Mailing address
1709 CHICKASAW DR, COLUMBUS, MS 39705-1430
(662) 241-4952
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2882-95
MS
122300000X
Dentist
Primary
5389 C
AL
1223P0300X
Periodontics
5389 C
AL
1223P0300X
Periodontics
PER-323-98
MS
Other
Enumeration date
08/25/2006
Last updated
09/11/2025
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