Individual
DR. FLORIAN NICKISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5486
(801) 587-5411
Mailing address
590 WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5486
(801) 587-5411
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2005-01034
NC
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
6475000-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901362
—
NC
05
—
N0103A
—
SC
Enumeration date
11/22/2005
Last updated
11/23/2021
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