Nicolas, Mark David

Nicolas, Mark David is an sole proprietor health care provider with primary practice located at 3800 S National Ave Ste 600 , Springfield MO 65807-5249. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Nicolas, Mark David can be contacted via phone (417) 875-3000.

Contact Information

Primary practice address
3800 S National Ave Ste 600 Springfield MO 65807-5249
Phone: (417) 875-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 2021027694 Missouri
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1447645221
LBN Legal business name Nicolas, Mark David
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2015
Last updated Sep 23rd, 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 1447645221 NPPES
Missouri MEDICAID 200100628

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