Organization
KYLE NICKEL MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE CHRISTIAN NICKEL M.D. (PRESIDENT)
(303) 929-1609
Entity
Organization
Contact information
Practice address
95 STAFFORD LN, DELTA, CO 81416-3465
(970) 874-8026
Mailing address
95 STAFFORD LN, DELTA, CO 81416-3465
(970) 874-8026
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33012
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48638013
—
CO
Enumeration date
10/01/2014
Last updated
10/01/2014
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