Organization
JOHN C. NICHOLSON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C NICHOLSON M.D. (PHYSICIAN OWNER)
(802) 524-4554
Entity
Organization
Contact information
Practice address
2 CREST RD, SAINT ALBANS, VT 05478-9753
(802) 524-4554
(802) 524-3216
Mailing address
PO BOX 1363, WILLISTON, VT 05495-1363
(802) 524-7100
(802) 524-7021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0420010190
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN2606
—
VT
Enumeration date
03/05/2007
Last updated
08/22/2020
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