Individual
NICHOLAS G VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 PHYSICIANS DRIVE, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Mailing address
24 PHYSICIANS DRIVE, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0040945
TX
207X00000X
Orthopaedic Surgery Physician
0101259929
VA
207X00000X
Orthopaedic Surgery Physician
Primary
56124
TN
207X00000X
Orthopaedic Surgery Physician
MD0000056124
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031011
—
TN
Enumeration date
05/11/2011
Last updated
12/02/2021
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