Individual
MR. THERRON SAMUEL NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 577-3075
Mailing address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 577-3075
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3209
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137570A
—
OK
Enumeration date
08/30/2006
Last updated
05/23/2013
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