Individual
CRAIG RANDAL NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5131 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-3800
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3800
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
MD00038184
WA
207RX0202X
Medical Oncology Physician
Primary
9586855-1205
UT
207RX0202X
Medical Oncology Physician
MD21496
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0276491
LABOR AND INDUSTRY
WA
05
—
1295743730
—
WA
05
—
159046
—
OR
05
—
8233512
—
WA
Enumeration date
08/03/2006
Last updated
02/02/2016
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