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
Fax: (334) 677-2206
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1518055334 NPPES
Florida MEDICAID 069046500
Florida MEDICAID 529906170
Florida MEDICAID 00296557C
Florida Other 51083586

Popular Providers