Individual
DALE ELLEN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1112 E WEISGARBER RD, STE 201, KNOXVILLE, TN 37909-2647
(865) 558-9862
(865) 584-3478
Mailing address
1112 E WEISGARBER RD, STE 201, KNOXVILLE, TN 37909-2647
(865) 558-9862
(865) 584-3478
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17155
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3051573
—
TN
05
—
3051574
—
TN
Enumeration date
06/28/2005
Last updated
09/02/2011
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