Nichols, Phillip Todd
Nichols, Phillip Todd is an sole proprietor health care provider with primary practice located at 500 Donnally St Suite 200, Charleston WV 25301-1648. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Nichols, Phillip Todd can be contacted via phone (304) 342-0124.Contact Information
Primary practice address
500 Donnally St Suite 200
Charleston WV 25301-1648
Phone: (304) 342-0124
Fax: (304) 340-2204
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 19053 | West Virginia |
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 0101273372 | Virginia |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 0101273372 | Virginia |
Profile Details
| NPI number | 1396744652 |
|---|---|
| LBN Legal business name | Nichols, Phillip Todd |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2005 |
| Last updated | May 28th, 2024 - about 2 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 | 1396744652 | NPPES |
| West Virginia | Other | 040014129 | RR MEDICARE |
| West Virginia | Other | 1157768001 | RR MEDICARE |
| West Virginia | MEDICAID | 0300079000 | RR MEDICARE |
| West Virginia | Other | 7979026 | RR MEDICARE |
| West Virginia | Other | 550595497023 | RR MEDICARE |
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