Individual
NICHOLAS JOSEPH VAN SICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3101 BEAUMONT CENTRE CIR STE 100, LEXINGTON, KY 40513-1959
(859) 323-5544
(859) 257-9286
Mailing address
1631 ELYSIAN FIELDS AVE, NEW ORLEANS, LA 70117-8208
(504) 821-2601
(504) 814-6047
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD.201407
LA
207R00000X
Internal Medicine Physician
MD.201407
LA
207RI0200X
Infectious Disease Physician
Primary
56921
KY
207RI0200X
Infectious Disease Physician
MD.201407
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215597
—
LA
Enumeration date
11/26/2007
Last updated
06/21/2022
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