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Individual

MICHAEL CARL NICOSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2400 EASTPOINT PKWY, SUITE 570, LOUISVILLE, KY 40223-4154
(502) 631-0601
(855) 852-7155
Mailing address
319 MOCKINGBIRD HILL RD, LOUISVILLE, KY 40207-1852
(502) 631-0601
(855) 852-7155

Taxonomy

Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
01074143A
IN
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
47277
KY

Other

Enumeration date
06/19/2007
Last updated
01/08/2015
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