Nichols, Dale Ellen

Nichols, Dale Ellen is an individual health care provider with primary practice located at 1112 E Weisgarber Rd Ste 201, Knoxville TN 37909-2647. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Nichols, Dale Ellen can be contacted via phone (865) 558-9862.

Contact Information

Primary practice address
1112 E Weisgarber Rd Ste 201 Knoxville TN 37909-2647
Phone: (865) 558-9862
Fax: (865) 584-3478
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 17155 Tennessee

Profile Details

NPI number 1770589350
LBN Legal business name Nichols, Dale Ellen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Sep 2nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770589350 NPPES
Tennessee MEDICAID 3051574
Tennessee MEDICAID 3051573

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