Individual
DR. NICKOLAS EVANGELOS POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
711 N TAYLOR ST, GUNNISON, CO 81230-2208
(970) 641-9482
(970) 642-4798
Mailing address
711 N TAYLOR ST, GUNNISON, CO 81230-2208
(970) 641-3927
(970) 642-4798
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DR.0059273
CO
207N00000X
Dermatology Physician
OS13474
FL
207ND0101X
MOHS-Micrographic Surgery Physician
DR.0059273
CO
207ND0101X
MOHS-Micrographic Surgery Physician
OS13474
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029298
KAISER COMMERCIAL NUMBER
CO
05
—
9000176165
—
CO
Enumeration date
06/28/2014
Last updated
06/11/2025
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