Individual
DR. GREGG F. NICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 FAIRWAY STREET, BOWLING GREEN, KY 42103-2477
(270) 781-3910
(270) 842-7177
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 780-2497
(270) 783-0454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37824
KY
207QA0505X
Adult Medicine Physician
37824
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080194783
RAILROAD MEDICARE
—
05
—
64061393
—
KY
Enumeration date
09/08/2005
Last updated
06/18/2015
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