Nichols, Michael R

Nichols, Michael R is an individual health care provider with primary practice located at 266 Katherine Dr , Jackson MS 39232-8801. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Other Service Providers / Specialist. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Nichols, Michael R can be contacted via phone (601) 420-3223.

Contact Information

Primary practice address
266 Katherine Dr Jackson MS 39232-8801
Phone: (601) 420-3223
Fax: (601) 420-3054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3119-00 Mississippi
Other Service Providers / Specialist 174400000X OS-340-00 Mississippi

Profile Details

NPI number 1427189224
LBN Legal business name Nichols, Michael R
Credentials D.M.D., M.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Jul 8th, 2007 - about 18 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 1427189224 NPPES
Mississippi MEDICAID 00213548

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