Individual
STEPHEN A NICKISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2060 DAN PROCTOR DR, SUITE 1200, SAINT MARYS, GA 31558-3894
(912) 540-6750
(912) 540-6773
Mailing address
2060 DAN PROCTOR DR STE 1200, SAINT MARYS, GA 31558-3895
(912) 540-6750
(912) 540-6773
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10278
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000099105
BCBS
—
05
—
0093279
—
MT
Enumeration date
07/09/2006
Last updated
12/09/2025
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