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General NPI Number Information
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NPI Number | 1285076380
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Entity Type | Organization
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Legal Business Name | DAVID NICHOLSON DO, LLC
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 4403 STATE ROUTE 725 STE A1
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City | BELLBROOK
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State | OH
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Zip | 45305-2700
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Country | US
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Telephone | 937-310-1218
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Fax | 937-310-1378
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Provider Business Mailing Address
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Address Line | 4403 STATE ROUTE 725 STE A1
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City | BELLBROOK
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State | OH
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Zip | 45305-2700
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Country | US
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Telephone | 937-310-1218
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Fax | 937-310-1378
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. DAVID SCOTT NICHOLSON
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Credential | D.O.
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Telephone | 937-310-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34008874
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License Number State | OH
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