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Individual

JOHN T NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1686 SKYLYN DR, SUITE 101, SPARTANBURG, SC 29307-1058
(864) 585-3456
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6749
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
326111
SC
01
P00708632
RR MEDICARE
SC
Enumeration date
05/18/2006
Last updated
02/27/2013
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