| NPI | 1306086384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE RICHARD NICHOLS Physician 573-876-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2008016028) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2008016028) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MO 2008016028) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2010-03-04 |