Nichols, Michael R
Nichols, Michael R is an individual health care provider with primary practice located at 266 Katherine Dr , Jackson MS 39232-8801. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Nichols, Michael R can be contacted via phone (601) 420-3223.Contact Information
Primary practice address
266 Katherine Dr
Jackson MS 39232-8801
Phone: (601) 420-3223
Fax: (601) 420-3054
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 3119-00 | Mississippi |
| Other Service Providers / Specialist | 174400000X | OS-340-00 | Mississippi |
Profile Details
| NPI number | 1427189224 |
|---|---|
| LBN Legal business name | Nichols, Michael R |
| Credentials | D.M.D., M.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2007 |
| Last updated | Sep 11th, 2025 - about last year |
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 | 1427189224 | NPPES |
| Mississippi | MEDICAID | 00213548 |
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