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Robert S Nickolisen, MD
Specialist in Parker, Arizona
NPI 1487692125

Robert S Nickolisen is a Specialist based in Lake Havasu City, AZ. Robert S Nickolisen practices in Parker, AZ and has the professional credentials of MD. The NPI Number for Robert S Nickolisen is 1487692125 and holds a License No. 15301 (Arizona).

The current practice location address for Robert S Nickolisen is 601 W Riverside Dr, Parker, AZ and can be reached out via phone at 602-377-5900.

Location: 601 W Riverside Dr, Parker, AZ, 86406-7622
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487692125
Provider Name
Robert S Nickolisen
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
601 W Riverside Dr, Parker, AZ, 86406-7622
Phone Number
602-377-5900
Fax Number
Provider Enumeration Date
06/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
250316 05 AZ
institution
Provider Business Practice Location Address Details
Address
601 W Riverside Dr
City
Parker
State
Arizona
Zip
85344-5119
Phone Number
602-377-5900
Fax Number
person
Provider Business Mailing Address Details
Address
601 W Riverside Dr
City
Parker
State
Arizona
Zip
85344-5119
Phone Number
602-377-5900
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
15301 (Arizona)
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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