Individual
DR. TODD APPLEWHITE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19880
MS
2085R0202X
Diagnostic Radiology Physician
T1824
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01484281
—
MS
05
—
178936
—
AL
01
—
P01194858
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/16/2007
Last updated
12/08/2015
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