Individual
DR. DAVID NICKELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ROSE ST, ROOM HX-315E, LEXINGTON, KY 40536-0001
(859) 323-5069
Mailing address
800 ROSE STREET, ROOM HX-315E, LEXINGTON, KY 40536-0293
(859) 323-5069
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
43406
KY
2085R0202X
Diagnostic Radiology Physician
Primary
43406
KY
2085R0202X
Diagnostic Radiology Physician
R1475
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100135410
—
KY
Enumeration date
11/14/2008
Last updated
08/27/2019
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