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General, Orthopedic, Thoracic, Vascular Surgery
Plastic, Cosmetic, Oral, Podiatric Surgery

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DR. CHARLES THOMAS NUCKOLS D.M.D.

Surgery Yellow Pages

Bowling Green, Kentucky

Provider NPI: 1245244474

Provider Information:
DR. CHARLES THOMAS NUCKOLS D.M.D.


Practice Location:
627 EASTWOOD AVE  BOWLING GREEN, KY 42103 US
Tel: 270-843-4341  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N204E00000XPhysicians
Oral & Maxillofacial Surgery
KY3399
Y1223S0112XDental Providers
Dentist
KY3399

Other Provider Identifiers:

IssuerNumberStateType
PASSPORT GROUP PIN1115671KY01
DORAL DENTAL ID6389KY01
ANTHEM PROVIDER ID000000212083KY01
60033990KY05
PASSPORT HEALTH ID PIN1069982KY01
64033996KY05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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