Joseph Eddy Nicolas, MD
Individual provider Active NPI Family Medicine Physician · Winnebago, NE
NPI 1588632525 · NPPES record last updated Mar 12, 2013
Key facts
- NPI
- 1588632525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 15143 (NE)
- Practice address
- Highway 75/77
Winnebago, NE 68071 - Phone
- (402) 878-2231
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27333 | IA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15143 | NE | Yes |
| Internal Medicine Physician | 207R00000X | 27333 | IA |
Addresses
Primary practice location
Highway 75/77
Winnebago, NE 68071
Mailing address
4832 Sunnybrook Dr
Sioux City, IA 51106
Phone (712) 274-7932
Other providers in Winnebago, NE
- Esther Rose Mercer
- Ahmed Hashim Mohammed
- Rex Khan Monif
- Lacee Murtaugh
- Chibuike Ezennaya Nduanya
- Isaac Neal Oaks
- Karen Ann Oaks
- Susan Porter
- Eric Ramirez
- Manuel Alvarez Rodriguez
All providers in Winnebago, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.