Healthcare Provider Details

I. General information

NPI: 1245358258
Provider Name (Legal Business Name): WILLIAM EUGENE NICHOLS JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 LEXINGTON AVE STE 310B
ASHLAND KY
41101-2893
US

IV. Provider business mailing address

PO BOX 2379
ASHLAND KY
41105-2379
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-1321
  • Fax: 606-408-6411
Mailing address:
  • Phone: 606-408-1290
  • Fax: 606-408-6640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4516
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number717
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number717
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: