Provider Demographics
NPI:1245358258
Name:NICHOLS, WILLIAM EUGENE JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EUGENE
Last Name:NICHOLS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-1290
Mailing Address - Fax:606-408-6640
Practice Address - Street 1:617 23RD ST STE 10
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2845
Practice Address - Country:US
Practice Address - Phone:606-408-1291
Practice Address - Fax:606-408-6411
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV717111N00000X, 111NS0005X
KY4516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY611347870OtherCIGNA
KY611347879OtherMEDICAL MUTUAL
KY7356029OtherAETNA
WV611347870OtherMANSBACH METAL CO.
KY001711779OtherMOUNTAIN ST. BLUE CROSS
KY611347870OtherHUMANA
KY000000064672OtherANTHEM
KY1178496OtherCHA
KY611347870OtherCOMPMANAGEMENT HEALTH
KY000000064672OtherKENTUCKY ACCESS
KY611347870OtherUNITED HEALTH CARE
KY85000701Medicaid
KY611347870OtherHUMANA