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NPI Code Detail

MEDICARE: DR. ROMAINE CHARLES NICHOLS JR. M.D.

MEDICARE: DR. ROMAINE CHARLES NICHOLS JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianME0056785FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679555270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMAINE CHARLES NICHOLS JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 116304
Second Line :
City : ATLANTA
State : GA
Zip : 30368-6304
Country : US
Telephone Number : 904-588-1800
Fax Number :
Provider Business Practice Location Address
First Line : 2015 JEFFERSON ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32206-3531
Country : US
Telephone Number : 904-588-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 10/20/2011

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