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Dr. Michael R Nichols, DMD,MD
Specialist in Jackson, Mississippi
NPI 1427189224

Michael R Nichols is a Specialist based in Jackson, MS. Michael R Nichols practices in Jackson, MS and has the professional credentials of DMD,MD. The NPI Number for Michael R Nichols is 1427189224 and holds a License No. 3119-00 (Mississippi).

The current practice location address for Michael R Nichols is 266 Katherine Dr, Jackson, MS and can be reached out via phone at 601-420-3223 and via fax at 601-420-3054.

Location: 266 Katherine Dr, Jackson, MS, 39232-8801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427189224
Provider Name
Michael R Nichols
Credential
DMD,MD
Provider Entity Type
Individual
Gender
Male
Address
266 Katherine Dr, Jackson, MS, 39232-8801
Phone Number
601-420-3223
Fax Number
601-420-3054
Provider Enumeration Date
03/07/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00213548 05 MS
institution
Provider Business Practice Location Address Details
Address
266 Katherine Dr
City
Jackson
State
Mississippi
Zip
39232-8801
Phone Number
601-420-3223
Fax Number
601-420-3054
person
Provider Business Mailing Address Details
Address
266 Katherine Dr
City
Jackson
State
Mississippi
Zip
39232-8801
Phone Number
601-420-3223
Fax Number
601-420-3054
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
OS-340-00 (Mississippi)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
3119-00 (Mississippi)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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