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Contact Information

PHILLIP T NICHOLS, MD
500 DONNALLY ST
SUITE 200
CHARLESTON, WV25301-1648
 Phone: 304-342-0124
 Fax: 304-340-2204
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for PHILLIP T NICHOLS · (Male)

NPI Number 1396744652
Status Active
Credentials MD
Entity Individual
Enumeration date 07/19/2005
Last updated 05/28/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0101273372
  • WV License # 19053
  • WV Medicaid 0300079000
  • WV Other 7979026 AETNA
  • WV Other 550595497023 BC/BS
  • WV Other 1157768001 CIGNA
  • WV Other 040014129 RR MEDICARE
Hospital affiliation(s)
  • COMMUNITY MEMORIAL HEALTHCENTER INC - (Acute Care)
    125 BUENA VISTA CIRCLE
    SOUTH HILL, VA 23970
  • MEDICAL COLLEGE OF VIRGINIA HOSPITALS - (Acute Care)
    1250 EAST MARSHALL STREET - BOX 980510
    RICHMOND, VA 23298
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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