Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01047116A | IN |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 43291 | AZ |
NPI | 1811979883 |
---|---|
Provider Name | Dr. James P Nicolai |
First Address | Tucson, AZ 85704-6313 |
Second Address | Tucson, AZ 85704-6313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 26/05/2015 |