Organization
NICEVILLE GENERAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 678-1154
Entity
Organization
Contact information
Practice address
1001 COLLEGE BLVD W, SUITE B-1, NICEVILLE, FL 32578-1099
(850) 678-1154
(850) 678-1458
Mailing address
1001 COLLEGE BLVD W, SUITE B-1, NICEVILLE, FL 32578-1099
(850) 678-1154
(850) 678-1458
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
11/09/2006
Last updated
10/01/2007
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