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Organization

NICHOLS MOHS AND SKIN SURGERY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GEORGE RICHARD NICHOLS M.D. (PHYSICIAN)
(573) 876-1000
Entity
Organization

Contact information

Practice address
303 N KEENE ST, SUITE 201, COLUMBIA, MO 65201-7193
(573) 876-1000
(573) 442-7899
Mailing address
303 N KEENE ST, SUITE 201, COLUMBIA, MO 65201-7193
(573) 876-1000
(573) 442-7899

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2008016028
MO
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2008016028
MO
207NS0135X
Procedural Dermatology Physician
2008016028
MO

Other

Enumeration date
03/03/2009
Last updated
03/04/2010
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