Nickelson, Robert A.

Nickelson, Robert A. is an individual health care provider with primary practice located at 2600 Kings Hwy Suite 340, Shreveport LA 71103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Nickelson, Robert A. can be contacted via phone (318) 212-8620.

Contact Information

Primary practice address
2600 Kings Hwy Suite 340 Shreveport LA 71103
Phone: (318) 212-8620
Fax: (318) 212-8625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 015593 Louisiana

Profile Details

NPI number 1023019064
LBN Legal business name Nickelson, Robert A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Dec 18th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1023019064 NPPES
Louisiana MEDICAID 1322741

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