Nichols, Gary Dale

Nichols, Gary Dale is an individual health care provider with primary practice located at 16Th Street Ctmc, Bldg 885, Fort Leonard Wood MO 65473. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Nichols, Gary Dale can be contacted via phone (573) 596-1680.

Contact Information

Primary practice address
16Th Street Ctmc, Bldg 885 Fort Leonard Wood MO 65473
Fax: (573) 596-0423

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02338 Texas

Profile Details

NPI number 1437140357
LBN Legal business name Nichols, Gary Dale
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jul 8th, 2007 - 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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