Provider Demographics
NPI:1306901517
Name:NICKELL, WILLIAM B (M,D)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:NICKELL
Suffix:
Gender:M
Credentials:M,D
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Mailing Address - Street 1:3745 DUNBARTON DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2739
Mailing Address - Country:US
Mailing Address - Phone:205-967-3843
Mailing Address - Fax:205-298-1440
Practice Address - Street 1:500 CAHABA PARK CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5087
Practice Address - Country:US
Practice Address - Phone:295-980-9393
Practice Address - Fax:205-980-4494
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2009-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL3370208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C75686Medicare UPIN