Organization
W. JOHN NICHOLAS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JOHN NICHOLAS MD (PHYSICIAN)
(417) 347-6400
Entity
Organization
Contact information
Practice address
3202 MCINTOSH CIR, STE LL03, JOPLIN, MO 64804-3646
(417) 347-6400
(417) 347-6404
Mailing address
PO BOX 4336, JOPLIN, MO 64803-4336
(417) 347-6400
(417) 347-6404
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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