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General NPI Number Information
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NPI Number | 1598467185
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Entity Type | Individual
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Provider Name | NICHOLAS JAMES METHENY DO
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Gender | Male
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | PSC 473 BOX 47 FPO AP
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City | YOKOSUKA
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State | KANAGAWA
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Zip | 96349
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Country | JP
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Telephone | 315-241-8016
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Fax |
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Provider Business Mailing Address
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Address Line | YOKOSUKA, HONCHO 2-1-19 RM#601 BLDG#2
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City | YOKOSUKA
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State | KANAGAWA
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Zip | 2380041
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Country | JP
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 21353
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License Number State | FL
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