Dr Susanne A Nichols, DMD is a
Dentist - General Practice based in Reform, Alabama. Dr Susanne A Nichols is licensed to practice in Mississippi (license number 2813-94) and her current practice location is
106 Third Avenue Southeast, Reform, Alabama. She can be reached at her office (for appointments etc.) via phone at
(205) 375-6314.
NPI number for Dr Susanne A Nichols is 1518047513 and her current mailing address is P.o. Box 672, 106 Third Avenue Southeast, Reform, Alabama. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1518047513.
Healthcare Provider's Profile
Full Name | Dr Susanne A Nichols |
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Gender | Female |
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Speciality | Dentist - General Practice |
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Location | 106 Third Avenue Southeast, Reform, Alabama |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1518047513
- Provider Enumeration Date: 10/16/2006
- Last Update Date: 04/04/2012
Medical Identifiers
Medical identifiers for Dr Susanne A Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518047513 | NPI | - | NPPES |
05778081 | Medicaid | MS | |
954583 | Other | MS | UNITED CONCORDIA DENTAL |
2813 | Other | MS | DELTA DENTAL |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 2813-94 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Susanne A Nichols is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Susanne A Nichols, DMD P.o. Box 672, 106 Third Avenue Southeast, Reform, AL 35481-2254 Ph: (205) 375-6314 | Dr Susanne A Nichols, DMD 106 Third Avenue Southeast, Reform, AL 35481-2254 Ph: (205) 375-6314 |
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