Paul G. Nicholas III, D.O., P.a.
Organization Active NPI Family Medicine Physician · Woodstown, NJ
NPI 1346462983 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1346462983
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MB040789 (NJ)
- Legal business name
- PAUL G. NICHOLAS III, D.O., P.A.
- Practice address
- 24 East Ave
Woodstown, NJ 08098-1409 - Phone
- (856) 769-0900
- Fax
- (856) 769-2639
- NPI assigned
- May 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Paul Nicholas III, D.O.
- Title
- Physician
- Phone
- (856) 769-0900
Practitioners 1
-
Paul George Nicholas III, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111215000684 | NJ | Part B Supplier - Clinic/Group Practice | 7810162021 |
Receives reassigned benefits from 1 practitioner Practice locations: Woodstown, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MB040789 | NJ | Yes |
Addresses
Primary practice location
24 East Ave
Woodstown, NJ 08098-1409
Mailing address
PO Box 304
24 East Ave
Woodstown, NJ 08098-0304
Phone (856) 769-0900
Other providers in Woodstown, NJ
- Emily Ann Morrison
- Paul George Nicholas III
- Pafacom, Inc.
- Brian J Pahlow
- Kristina M. Parkin
- Gianna Paul
- Physician Shockwaver Therapy
- Physiotherapy Associates Inc
- Emily Rafferty
- Chasady Rice
All providers in Woodstown, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.