Nichols, Randall Wayne
Nichols, Randall Wayne is an sole proprietor health care provider with primary practice located at 2431 W Main St Suite 1001, Dothan AL 36301-1217. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Nichols, Randall Wayne can be contacted via phone (334) 677-6220.Contact Information
Primary practice address
2431 W Main St Suite 1001
Dothan AL 36301-1217
Phone: (334) 677-6220
Fax: (334) 677-2206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 9258 | Alabama |
Profile Details
| NPI number | 1518055334 |
|---|---|
| LBN Legal business name | Nichols, Randall Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | May 8th, 2017 - about 9 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 | 1518055334 | NPPES |
| Florida | MEDICAID | 069046500 | |
| Florida | MEDICAID | 529906170 | |
| Florida | MEDICAID | 00296557C | |
| Florida | Other | 51083586 |
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