Dr Wendell Allan Nickerson, DO is a
Family Medicine physician based in Shelbina, Missouri. Dr Wendell Allan Nickerson is licensed to practice in Missouri (license number R9E45) and his current practice location is 400 S Center St, Shelbina, Missouri. He can be reached at his office (for appointments etc.) via phone at
(573) 588-4131.
NPI number for Dr Wendell Allan Nickerson is 1437249588 and his current mailing address is 400 S Center St, Shelbina, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1437249588.
Physician's Profile
| Full Name | Dr Wendell Allan Nickerson |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 400 S Center St, Shelbina, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1437249588
- Provider Enumeration Date: 10/12/2006
- Last Update Date: 01/15/2019
Medical Identifiers
Medical identifiers for Dr Wendell Allan Nickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437249588 | NPI | - | NPPES |
| 509038808 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | R9E45 (Missouri) | 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 Wendell Allan Nickerson 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 Wendell Allan Nickerson, DO
400 S Center St,
Shelbina, MO 63468-1404
Ph: (573) 588-4131 | Dr Wendell Allan Nickerson, DO
400 S Center St,
Shelbina, MO 63468-1404
Ph: (573) 588-4131 |
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