| Dr Heather Ruthann Nichols, MD | |
|
514 S 9th St, Vincennes, IN 47591-2709 | |
| (812) 882-8510 | |
| (812) 885-8511 |
| Full Name | Dr Heather Ruthann Nichols |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 514 S 9th St, Vincennes, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366642365 | NPI | - | NPPES |
| 000000681708 | Other | IN | ANTHEM |
| 201003480 | Medicaid | IN | |
| 262813100 | Other | IN | TAX ID |
| 26-3086555 | Other | IN | TAX I.D. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 01068320A (Indiana) | Primary |
| Entity Name | Good Samaritan Hospital Physician Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649432071 PECOS PAC ID: 3971671330 Enrollment ID: O20081013000182 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Heather Ruthann Nichols, MD 514 S 9th St, Vincennes, IN 47591-2709 Ph: (812) 882-8510 | Dr Heather Ruthann Nichols, MD 514 S 9th St, Vincennes, IN 47591-2709 Ph: (812) 882-8510 |
Noel O Suanes, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 | |
Kenneth W Buehlman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 | |
Dr. Kathleen B Stutz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 520 S 7th St, Vincennes, IN 47591 Phone: 812-882-5220 Fax: 812-885-3769 | |
Jerick C Pacheco, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 |