Individual
MARGARET ELLEN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 MCINTOSH CIR STE 100, JOPLIN, MO 64804-3651
(417) 347-7200
Mailing address
PO BOX 3810, JOPLIN, MO 64803
(417) 347-4662
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
100641
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176210E
—
KS
05
—
100194580A
—
OK
05
—
203393418
—
MO
01
—
28372
ANTHEM
MO
01
—
P00059303
RR MEDICARE
—
Enumeration date
06/20/2006
Last updated
03/19/2024
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