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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