Individual
JOHN STEPHAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11750 W 2ND PL, SUITE 255, LAKEWOOD, CO 80228-1575
(720) 321-8040
(720) 321-8041
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
26919
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01269190
—
CO
Enumeration date
08/08/2006
Last updated
04/23/2018
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