Nichols, Willis Tyler
Nichols, Willis Tyler is an individual health care provider with primary practice located at 1711 N Mckenzie St Ste 201 , Foley AL 36535-2282. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Nichols, Willis Tyler can be contacted via phone (251) 424-1620.Contact Information
Primary practice address
1711 N Mckenzie St Ste 201
Foley AL 36535-2282
Phone: (251) 424-1620
Fax: (251) 952-6620
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 34161 | Alabama |
Profile Details
| NPI number | 1063722684 |
|---|---|
| LBN Legal business name | Nichols, Willis Tyler |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2010 |
| Last updated | Sep 12th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063722684 | NPPES |
| Alabama | MEDICAID | 214769 | |
| Alabama | MEDICAID | 105926100 | |
| Alabama | MEDICAID | 211911 | |
| Alabama | MEDICAID | 00187592 |
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