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General NPI Number Information
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NPI Number | 1508967910
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Entity Type | Organization
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Legal Business Name | NICHOLAS LANDRY D.O. INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 1354 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-2601
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Country | US
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Telephone | 740-441-9800
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Fax | 740-441-9400
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Provider Business Mailing Address
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Address Line | 1325 NORTHUP RD
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City | GALLIPOLIS
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State | OH
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Zip | 45631-8830
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Country | US
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Telephone | 740-441-9800
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Fax | 740-441-9400
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Authorized Official
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Title or Position | CEO
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Name | DR. NICHOLAS V LANDRY
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Credential | D.O.
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Telephone | 740-441-9800
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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 |
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License Number State |
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