Individual
CHAD L. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5200 E I 240 SERVICE RD, OKLAHOMA CITY, OK 73135-2607
(405) 628-6000
(405) 628-6792
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
990
OK
363AS0400X
Surgical Physician Assistant
PA03727
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108590A
—
OK
Enumeration date
10/05/2006
Last updated
10/26/2022
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