Nickens, Larry C
Nickens, Larry C is an individual health care provider with primary practice located at 2706 Medical Office Place , Goldsboro NC 27534-9460. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Nickens, Larry C can be contacted via phone (919) 734-4736.Contact Information
Primary practice address
2706 Medical Office Place
Goldsboro NC 27534-9460
Phone: (919) 734-4736
Fax: (919) 580-1017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 27762 | North Carolina |
Profile Details
| NPI number | 1619040532 |
|---|---|
| LBN Legal business name | Nickens, Larry C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Jun 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619040532 | NPPES |
| Other | 62640 | BCBS | |
| Other | 28723 | BCBS |
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