Nuckols, Charles Thomas

Nuckols, Charles Thomas is an individual health care provider with primary practice located at 627 Eastwood Ave , Bowling Green KY 42103-1688. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Nuckols, Charles Thomas can be contacted via phone (270) 843-4341.

Contact Information

Primary practice address
627 Eastwood Ave Bowling Green KY 42103-1688
Phone: (270) 843-4341
Fax: (270) 746-9551
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3399 Kentucky
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 3399 Kentucky

Profile Details

NPI number 1245244474
LBN Legal business name Nuckols, Charles Thomas
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jan 10th, 2008 - about 16 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 1245244474 NPPES
Kentucky Other 000000212083 ANTHEM PROVIDER ID
Kentucky Other 6389 ANTHEM PROVIDER ID
Kentucky Other 1115671 ANTHEM PROVIDER ID
Kentucky MEDICAID 60033990 ANTHEM PROVIDER ID
Kentucky MEDICAID 64033996 ANTHEM PROVIDER ID
Kentucky Other 1069982 ANTHEM PROVIDER ID

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