Individual
KENNETH NICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
555 JUSTIS DR, GREENEVILLE, TN 37745-4288
(423) 783-7965
(423) 783-7970
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2153
TN
Other
Enumeration date
12/20/2006
Last updated
04/17/2018
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