Nuckols, Douglas A
Nuckols, Douglas A is an individual health care provider with primary practice located at 10021 Dupont Circle Ct , Fort Wayne IN 46825-1604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Nuckols, Douglas A can be contacted via phone (260) 426-8117.Contact Information
Primary practice address
10021 Dupont Circle Ct
Fort Wayne IN 46825-1604
Phone: (260) 426-8117
Fax: (260) 420-0817
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 01052220A | Indiana |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 35-07-8501 | Ohio |
Profile Details
| NPI number | 1982696837 |
|---|---|
| LBN Legal business name | Nuckols, Douglas A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Nov 20th, 2009 - about 15 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 | 1982696837 | NPPES |
| Indiana | MEDICAID | 200262190 | |
| Indiana | MEDICAID | 2207543 |
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