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General NPI Number Information
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NPI Number | 1194257634
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Entity Type | Individual
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Provider Name | NICHOLAS JOHN ERICKSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD EAST STE 702
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City | TUSCALOOSA
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State | AL
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Zip | 35401
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Country | US
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Telephone | 205-759-7561
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Fax | 205-759-7022
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Provider Business Mailing Address
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Address Line | 3901 GREENBORO AVE STE A
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City | TUSCALOOSA
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State | AL
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Zip | 35405
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Country | US
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Telephone | 205-333-4655
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD.37665
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License Number State | AL
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