Organization
ALPHONSO E. NICHOLS, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALPHONSO E NICHOLS M.D. (OWNER)
(502) 817-0927
Entity
Organization
Contact information
Practice address
2700 VISSING PARK RD, JEFFERSONVILLE, IN 47130-5989
(812) 284-8000
Mailing address
PO BOX 45, LA GRANGE, KY 40031-0045
(502) 817-0927
(502) 222-8745
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01061506A
IN
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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