Nickell, William David

Nickell, William David is an individual health care provider with primary practice located at 3533 Southern Blvd Ste 5650 , Kettering OH 45429-1263. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Nickell, William David can be contacted via phone (937) 294-3611.

Contact Information

Primary practice address
3533 Southern Blvd Ste 5650 Kettering OH 45429-1263
Phone: (937) 294-3611
Fax: (937) 294-9010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003357 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 003357 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 003357 Ohio

Profile Details

NPI number 1376826925
LBN Legal business name Nickell, William David
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2011
Last updated Jan 7th, 2021 - about 3 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 1376826925 NPPES
Ohio MEDICAID 0085670
Ohio Other 12286408

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