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Individual

TIMOTHY P NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
615 N BONITA AVE, PANAMA CITY, FL 32401-3623
(888) 313-5258
(205) 313-5298
Mailing address
2762 CONTINENTAL DR, STE 201, BATON ROUGE, LA 70808-3240
(888) 313-5258
(205) 313-5298

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
72507
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
255405400
FL
01
42672
BCBSF GRP # 98513
FL
Enumeration date
08/15/2005
Last updated
06/08/2016
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