Individual
JACOB NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 4TH ST, MS 9410, LUBBOCK, TX 79430
(806) 743-6840
Mailing address
3601 4TH ST, MS 9410, LUBBOCK, TX 79430-0002
(806) 743-6840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R5299
TX
207RI0200X
Infectious Disease Physician
Primary
R5299
TX
208M00000X
Hospitalist Physician
R5299
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2014
Last updated
12/02/2021
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