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Mark David Nicolas
Student in an Organized Health Care Education/Training Program in Springfield, Missouri
NPI 1447645221

Mark David Nicolas is a Student in an Organized Health Care Education/Training Program based in Kansas City, MO. Mark David Nicolas practices in Springfield, MO. The NPI Number for Mark David Nicolas is 1447645221 and holds a License No. 2021027694 (Missouri).

The current practice location address for Mark David Nicolas is 3800 S National Ave Ste 600, Springfield, MO and can be reached out via phone at 417-875-3000.

Location: 3800 S National Ave Ste 600, Springfield, MO, 64180-2843
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1447645221
Provider Name
Mark David Nicolas
Credential
Provider Entity Type
Individual
Gender
Male
Address
3800 S National Ave Ste 600, Springfield, MO, 64180-2843
Phone Number
417-875-3000
Fax Number
Provider Enumeration Date
03/30/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200100628 05 MO
institution
Provider Business Practice Location Address Details
Address
3800 S National Ave Ste 600
City
Springfield
State
Missouri
Zip
65807-5249
Phone Number
417-875-3000
Fax Number
person
Provider Business Mailing Address Details
Address
3800 S National Ave Ste 600
City
Springfield
State
Missouri
Zip
65807-5249
Phone Number
417-875-3000
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Trauma Surgery
Taxonomy
2086S0127X
License No.
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Definition
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
2021027694 (Missouri)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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