Individual
DR. JAMES ROBERT NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13838 S 46TH PL, STE 320, PHOENIX, AZ 85044-7804
(480) 759-5151
(480) 940-8649
Mailing address
13838 S 46TH PL, STE 320, PHOENIX, AZ 85044-7804
(480) 759-5151
(480) 940-8649
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
29489
AZ
207Q00000X
Family Medicine Physician
Primary
29489
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GRP
—
05
—
586018
—
AZ
01
—
AW1436
HEALTHNET GRP
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD GR
AZ
Enumeration date
11/04/2005
Last updated
03/20/2008
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