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Contact Information

TODD A NICHOLS, MD
2500 NORTH STATE STREET
JACKSON, MS39216
 Phone: 601-984-2538
 Fax: 601-815-1854
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for TODD A NICHOLS · (Male)

NPI # 1487853859
Status Active
Credentials MD
Entity Individual
Enumeration date 07/16/2007
Last updated 12/08/2015 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 19880
  • MS License # T1824
  • AL Medicaid 178936
  • MS Medicaid 01484281
  • MS Other P01194858 RAILROAD MEDICARE PTAN
Hospital affiliation(s)
  • MISSISSIPPI BAPTIST MEDICAL CENTER - (Acute Care)
    1225 N STATE ST
    JACKSON, MS 39202
  • RIVER REGION HEALTH SYSTEM - (Acute Care)
    2100 HWY 61 N
    VICKSBURG, MS 39183
  • UNIVERSITY OF MISSISSIPPI MED CENTER - (Acute Care)
    2500 N STATE ST
    JACKSON, MS 39216
  • UNIVERSITY OF MISSISSIPPI MEDICAL CENTER- GRENADA - (Acute Care)
    960 AVENT DRIVE
    GRENADA, MS 38901
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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