Provider Demographics
NPI:1598028698
Name:HARKER, NICKOLAS GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:NICKOLAS
Middle Name:GRANT
Last Name:HARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 51088
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-1088
Mailing Address - Country:US
Mailing Address - Phone:307-233-0246
Mailing Address - Fax:307-237-5421
Practice Address - Street 1:3632 AMERICAN WAY STE A
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3164
Practice Address - Country:UM
Practice Address - Phone:307-234-6765
Practice Address - Fax:307-234-6998
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2016-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY9701A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine