Individual
DR. JERRAD NICKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Mailing address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34010890
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089986
—
OH
05
—
1699057331
—
WV
05
—
7100258330
—
KY
Enumeration date
09/19/2011
Last updated
04/13/2021
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