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General NPI Number Information
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NPI Number | 1902919301
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Entity Type | Individual
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Provider Name | CHRISTOPHER WILLIAM NICHOLS MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 3377 RIVERBEND DR
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City | SPRINGFIELD
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State | OR
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Zip | 97477-8803
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Country | US
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Telephone | 541-222-8400
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Fax | 541-222-8401
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Provider Business Mailing Address
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Address Line | 3377 RIVERBEND DR
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City | SPRINGFIELD
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State | OR
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Zip | 97477-8803
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Country | US
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Telephone | 541-222-8400
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Fax | 541-222-8401
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD227336
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 47802
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 47802
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 47802
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License Number State | CO
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