Individual
NICHOLAS EUGENE MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2483
(504) 842-4023
Mailing address
4556 WHISPER WAY, PENSACOLA, FL 32504-6752
(305) 393-5653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
330560
LA
207R00000X
Internal Medicine Physician
33988
MS
207R00000X
Internal Medicine Physician
OS17765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330560
LICENSE
LA
01
—
33988
LICENSE
MS
01
—
OS17765
LICENSE
FL
Enumeration date
03/19/2018
Last updated
03/26/2026
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