DAVID J NICHOLSON, D.O. - NPI NUMBER 1083779466

Summary

Provider Name: DAVID J NICHOLSON, D.O.

NPI Number: 1083779466

Clasification: Internal Medicine (207R00000X)

Organization: OHIOHEALTH CORPORATION

Address:
765 N HAMILTON RD
GAHANNA, OH
ZIP 43230

Phone Number: (614) 533-5000



Detailed Information

David J Nicholson, D.O. is an internist in Gahanna, OH with 10 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. The assigned NPI number for this provider is 1083779466 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OHIO UNIVERSITY OF OSTEO MEDICINE
Graduation Year: 2004

The provider's business address is:

765 N HAMILTON RD
GAHANNA, OH
ZIP 43230-703
Phone: (614) 533-5000
Fax: (614) 533-5059

The enumeration date for this NPI number is 12/26/2006 and was last updated on 12/16/2013.

Map - Location of Practice

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Taxonomy Codes

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 207R00000X Internal Medicine 34008840 OH No
2 207RC0000X Internal Medicine Cardiovascular Disease 34.008840 OH Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 2729908 MEDICAID OH
2 H014130 MEDICARE PIN OH

NPI Record

No. Field Name Field Value
1 NPI 1083779466
2 Entity Type Code 1
3 Provider Last Name Legal Name NICHOLSON
4 Provider First Name DAVID
5 Provider Middle Name J
6 Provider Credential Text D.O.
7 Provider First Line Business Practice Location Address 765 N HAMILTON RD
8 Provider Business Practice Location Address City Name GAHANNA
9 Provider Business Practice Location Address State Name OH
10 Provider Business Practice Location Address Postal Code 432308703
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 6145335000
13 Provider Business Practice Location Address Fax Number 6145335059
14 Provider Enumeration Date 12/26/2006
15 Last Update Date 12/16/2013
16 Provider Gender Code M
17 Healthcare Provider Taxonomy Code 1 207R00000X
18 Provider License Number 1 34008840
19 Provider License Number State Code 1 OH
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 207RC0000X
22 Provider License Number 2 34.008840
23 Provider License Number State Code 2 OH
24 Healthcare Provider Primary Taxonomy Switch 2 Y
25 Other Provider Identifier 1 2729908
26 Other Provider Identifier Type Code 1 05
27 Other Provider Identifier State 1 OH
28 Other Provider Identifier 2 H014130
29 Other Provider Identifier Type Code 2 08
30 Other Provider Identifier State 2 OH
31 Is Sole Proprietor N

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.