Individual
LEE NICHOLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Mailing address
426 W COLLEGE ST, FLORENCE, AL 35630-5521
(256) 718-4041
(256) 718-3665
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16182
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009996510
—
AL
05
—
181487
—
AL
01
—
51507189
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
01
—
51515546
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
01
—
753040383
TAX ID
AL
Enumeration date
01/22/2007
Last updated
07/20/2016
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