Individual
ROWAN REECE NICKOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
280 LOONEY RD, SUITE 204, PIQUA, OH 45356-4199
(937) 773-4123
(937) 773-7717
Mailing address
280 LOONEY RD, SUITE 204, PIQUA, OH 45356-4199
(937) 773-4123
(937) 773-7717
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
47329
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0240840
GR MEDICAID NUMBER
OH
05
—
0572983
—
OH
01
—
MI9912194
GR MEDICARE NUMBER
—
Enumeration date
08/12/2005
Last updated
11/27/2013
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