Individual
FREDERICK R NUSBICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 226-9141
(229) 228-0637
Mailing address
PO BOX 2968, THOMASVILLE, GA 31799-2968
(229) 226-9141
(229) 228-0637
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
GA031805
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000398538A
PEACH STATE
GA
05
—
000398538A
—
GA
01
—
200009782
RAIL ROAD MEDICARE
GA
01
—
344368
WELLCARE
GA
Enumeration date
02/07/2006
Last updated
05/27/2008
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