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Individual

DAVID SCOTT NICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
56 CROWN DR, BIG HORN, WY 82833
(307) 674-9875
(307) 678-7393
Mailing address
56 CROWN DRIVE, BIG HORN, WY 82833-0278

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2688A
WY

Other

Enumeration date
10/14/2014
Last updated
10/14/2014
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