Susan Nicklin is a Pediatrics in Medford, Oregon. Susan Nicklin practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Susan Nicklin is 1790814200. The last update date is 2007-07-08.
Susan Nicklin's current location address is 100 E Main St, Medford, Oregon. You can contact this provider via phone number 5417895526 and fax number 5417895203. The mailing address for Susan Nicklin is 100 E Main St, Medford, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Nicklin |
|---|---|
| Address | 100 E Main St, Medford, Oregon |
| Phone Number | 5417895526 |
| Fax Number | 5417895203 |
| Sole Proprietor | N |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1790814200 |
|---|---|
| Provider Enumeration Date | 2007-03-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 100 E Main St |
|---|---|
| City | Medford |
| State | Oregon (OR) |
| Post Code | 975016041 |
| Phone Number | 5417895526 |
| Fax Number | 5417895203 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | 3217 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 183097 | OR | -- |
Post Comment/ Review Below
What is the Susan Nicklin's unique identification number?
The Susan Nicklin has been assigned the NPI (National Provider Identifier) Number 1790814200 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Susan Nicklin is physically located?
The Susan Nicklin is physically situated at the following address: 100 E Main St, Medford, OR, 975016041.
What is the Susan Nicklin's area of specialization and corresponding taxonomy classification?
The Susan Nicklin's specialty field is Pediatrics, and it falls under the taxonomy code 2251P0200X, which categorizes healthcare providers based on their specialties.
On what date did the Susan Nicklin receive its 1790814200 assignment from the Centers for Medicare & Medicaid Services?
The Susan Nicklin was assigned its 1790814200 by the Centers for Medicare & Medicaid Services on 2007-03-02.
When was the information related to Susan Nicklin most recently updated or refreshed?
The details pertaining to the Susan Nicklin, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC