DR. CHARLES THOMAS NUCKOLS (NPI# 1245244474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245244474 |
Entity Type | Individual |
Full Name | DR. CHARLES THOMAS NUCKOLS |
Credential | D.M.D. |
Practice Address |
627 Eastwood Ave Bowling Green KY 42103-1688 |
Practice Telephone | 2708434341 |
Practice Fax Number | 2707469551 |
Mailing Telephone | 2708434341 |
Mailing Fax Number | 2707469551 |
Enumeration Date | 2006-07-27 |
Last Update Date | 2008-01-10 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3399 | KY | Dental Providers |
N | 204E00000X | Oral & Maxillofacial Surgery | 3399 | KY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | PASSPORT GROUP PIN | 1115671 | 01 |
KY | DORAL DENTAL ID | 6389 | 01 |
KY | ANTHEM PROVIDER ID | 000000212083 | 01 |
KY | 60033990 | 05 | |
KY | PASSPORT HEALTH ID PIN | 1069982 | 01 |
KY | 64033996 | 05 |
Street Address |
627 EASTWOOD AVE |
City | BOWLING GREEN |
State | KY |
Zip Code | 42103-1688 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548388978 | Phillip Patrick Vanmeter | Dentist | 627 Eastwood Ave, Bowling Green, KY 42103-1688 | 2007-03-26 |
1447393079 | Norman Dale Thomas | Dentist | 627 Eastwood Ave, Bowling Green, KY 42103-1688 | 2007-02-14 |
1760525307 | Karen Mitchell Thomas | Dentist | 627 Eastwood Ave, Bowling Green, KY 42103-1688 | 2007-02-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
Find all providers in zip 42103 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477707784 | Nuckols & Cohron, P.s.c. | Dentist | 627 Eastwood St, Bowling Green, KY 42103-1688 | 2008-11-13 |
1134283765 | Mark S Allen | Dentist | 1716 Ashley Cir, Bowling Green, KY 42104-3366 | 2006-12-20 |
1679676191 | Edyee Mullins Sturgill | Dentist | 895 Wilkinson Trce Ste B, Bowling Green, KY 42103-2486 | 2006-09-07 |
1841282027 | Brian M O'neill | Dentist | 970 W Wooster St, Ste 126, Bowling Green, OH 43402-2643 | 2005-08-16 |
1164527420 | Tony Brandon Greer | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2006-09-13 |
1982696175 | Oral & Maxillofacial Surgeons Inc | Dentist | 970 W Wooster St, Suite 126, Bowling Green, OH 43402-2643 | 2005-08-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
1982058590 | Heine, Heine and Bowles, Pllc | Dentist | 2850 Lone Oak Rd Ste 5, Paducah, KY 42003-8043 | 2016-04-20 |
1326400789 | Corey Alan Taylor | Dentist | 800 Rose St # D-538, Lexington, KY 40536-7001 | 2016-03-24 |
1689060808 | Brandyn Herman | Dentist | Uk Dentistry At Turfland, 2195 Harrodsburg Rd, Ste 175, Lexington, KY 40536 | 2015-04-14 |
1619243268 | William J Curtis | Dentist | 800 Rose St Rm D508, University of Kentucky College of Dentistry, Lexington, KY 40536-0297 | 2012-03-28 |
1558651554 | Robbie James Harris IIi | Dentist | 4975 Alben Barkley Dr Ste 4, Paducah, KY 42001-6722 | 2011-04-11 |
1053541219 | Andrew William Ray | Dentist | 2421 Gooseberry Cir, Lexington, KY 40509-8567 | 2009-07-22 |
1407096639 | Charles William Langford Jr. | Dentist | 445 Stableford Cir, Owensboro, KY 42303-7771 | 2009-02-27 |
1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
Find all providers with the same taxonomy |
City | BOWLING GREEN |
Zip Code | 42103 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.