Individual
JAMES NICHOLAS CODE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4003 KRESGE WAY, SUITE 500, LOUISVILLE, KY 40207-4652
(502) 897-1166
(502) 897-1461
Mailing address
2700 STANLEY GAULT PKWY, STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4917
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
38541
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000652542
ANTHEM
KY
01
—
3770833000
PASSPORT ADVANTAGE
KY
01
—
50027678
PASSPORT
KY
05
—
7100019460
—
KY
Enumeration date
02/26/2007
Last updated
12/02/2020
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