Provider Demographics
NPI:1063157634
Name:NICHOLAS GEORGELOS, DO
Entity type:Organization
Organization Name:NICHOLAS GEORGELOS, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGELOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-913-9072
Mailing Address - Street 1:PO BOX 331244
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-7512
Mailing Address - Country:US
Mailing Address - Phone:630-913-9072
Mailing Address - Fax:
Practice Address - Street 1:1000 PHYSICIANS WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1471
Practice Address - Country:US
Practice Address - Phone:615-721-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty