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General NPI Number Information
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NPI Number | 1235150384
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Entity Type | Organization
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Legal Business Name | JOHN H NICHOLSON DO PC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 169 DELAWARE AVE
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City | PALMERTON
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State | PA
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Zip | 18071-1708
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Country | US
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Telephone | 610-826-5805
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Fax |
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Provider Business Mailing Address
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Address Line | 169 DELAWARE AVE
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City | PALMERTON
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State | PA
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Zip | 18071-1708
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Country | US
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Telephone | 610-826-5805
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. JOHN H NICHOLSON
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Credential | DO
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Telephone | 610-826-5805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS003895L
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License Number State | PA
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