Organization
THOMAS NICOTRI JR MD LLC
Active
Organization
THOMAS NICOTRI JR MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS NICOTRI JR. MD (PRESIDENT)
(985) 626-6996
Entity
Organization
Contact information
Practice address
1305 W CAUSEWAY APPROACH STE 209, MANDEVILLE, LA 70471-3043
(985) 626-6996
(985) 626-6995
Mailing address
PO BOX 1536, MANDEVILLE, LA 70470-1536
(985) 662-6699
(985) 626-6995
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
023801
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1485268
—
LA
Enumeration date
11/15/2006
Last updated
11/05/2007
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