Provider Demographics
NPI:1134532450
Name:NICHOLSON, AUSTIN CHANDLER (MD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:CHANDLER
Last Name:NICHOLSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE STE 220
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1168
Mailing Address - Country:US
Mailing Address - Phone:770-429-0083
Mailing Address - Fax:770-425-0137
Practice Address - Street 1:55 WHITCHER ST NE STE 220
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1168
Practice Address - Country:US
Practice Address - Phone:770-429-0083
Practice Address - Fax:770-425-0137
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS25204207R00000X
WAMD60948644207R00000X, 208M00000X
GA97689208M00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist