Individual
JOSEPH A NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2449 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2399
(318) 425-8701
(318) 425-0376
Mailing address
2449 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2399
(318) 425-8701
(318) 425-0376
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200400
LA
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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