DR. WILLIAM CLYDE NICHOLAS MD NPI 1871513895

NPI Information

NPI: 1871513895
Provider Name: DR. WILLIAM CLYDE NICHOLAS, MD
Classification: Internal Medicine - 207RE0101X
Entity Type: Individual

Specialization: Endocrinology, Diabetes & Metabolism

Address:
2500 NORTH STATE STREET
DEPARTMENT OF MEDICINE DIVISION OF ENDOCRINOLOGY
JACKSON, MS
ZIP 39216
Phone: (601) 984-5525
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DR. William Clyde Nicholas, MD is an endocrinology and diabetes and metabolism internal medicine in Jackson, MS. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. DR. William Clyde Nicholas, MD NPI is 1871513895. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2500 NORTH STATE STREET
DEPARTMENT OF MEDICINE DIVISION OF ENDOCRINOLOGY
JACKSON, MS
ZIP 39216-500
Phone: (601) 984-5525

The enumeration date for this NPI number is 7/20/2006 and was last updated on 6/14/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	08290	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	B30453	MEDICARE UPIN	MISSISSIPPI
2	0017122	MEDICAID	MISSISSIPPI
3	302I467196	MEDICARE PIN	MISSISSIPPI
4	512I110032	MEDICARE PIN	MISSISSIPPI
5	P00629131	MEDICARE PIN	MISSISSIPPI
6	1960802	MEDICAID	LOUISIANA
7	RR 110127661	OTHER	MISSISSIPPI	RAILROAD
8	110000343	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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