Nicklas, Edward Wilson

Nicklas, Edward Wilson is an individual health care provider with primary practice located at 1605 S 31St St , Temple TX 76508-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Nicklas, Edward Wilson can be contacted via phone (254) 215-0100.

Contact Information

Primary practice address
1605 S 31St St Temple TX 76508-0001
Phone: (254) 215-0100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 200500090 North Carolina
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X K7464 Texas

Profile Details

NPI number 1639138605
LBN Legal business name Nicklas, Edward Wilson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Mar 25th, 2016 - about 10 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 1639138605 NPPES
North Carolina MEDICAID 5900441

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