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Individual

TRENT L NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL CENTER BLVD, SUITE 103, COOKEVILLE, TN 38501-4294
(931) 783-2770
(931) 525-1176
Mailing address
127 N OAK AVE, SUITE D, COOKEVILLE, TN 38501-2435
(931) 783-5857
(931) 526-6760

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
18410
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3047248
TN
01
4352400
BCBS
TN
05
64795180
KY
Enumeration date
10/17/2006
Last updated
05/15/2017
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