Dr. Charles Thomas Nuckols
Dentist (Oral and Maxillofacial Surgery)

Address: 627 Eastwood Ave, Bowling Green, KY 42103-1688
Phone: 2708434341

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).

Provider Overview

Nation Provider Identifier (NPI) 1245244474
Entity Type Individual
Full Name Dr. Charles Thomas Nuckols
Credential D.M.D.
Gender Male
Practice Address 627 Eastwood Ave
Bowling Green
KY 42103-1688
Practice Telephone 2708434341
Practice Fax Number 2707469551
Mailing Address 627 Eastwood Ave
Bowling Green
KY 42103-1688
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-07-27
Last Update Date 2008-01-10

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 204E00000X Oral & Maxillofacial Surgery Allopathic & Osteopathic Physicians 3399 KY
Yes 1223S0112X Dentist · Oral and Maxillofacial Surgery Dental Providers 3399 KY

Other Provider Identifier

State Identifier Issuer Type Code
KY 1115671 OTHER PASSPORT GROUP PIN
KY 6389 OTHER DORAL DENTAL ID
KY 000000212083 OTHER ANTHEM PROVIDER ID
KY 60033990 MEDICAID
KY 1069982 OTHER PASSPORT HEALTH ID PIN
KY 64033996 MEDICAID

Physician Overview

NPI 1245244474
PAC ID by PECOS 2163557380
Professional Enrollment ID I20100312000790
Full Name Charles T Nuckols
Gender M
Medical School UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY
Graduation Year 1962
Primary Specialty ORAL SURGERY
Accepts Medicare Assignment Y

Office Location

Street Address 627 EASTWOOD AVE
City BOWLING GREEN
State KY
Zip Code 42103-1688

Providers in the same location

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

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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
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
1063864056 Gilbert Barbee Moore & Mcilvoy Psc Durable Medical Equipment & Medical Supplies 165 Natchez Trace Ave Ste 100&200, Bowling Green, KY 42103 2016-07-01
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
1952578593 Steven Snodgrass Surgery 996 Wilkinson Trace, Suite B 3, Bowling Green, KY 42103 2008-05-13
Find all providers in zip 42103

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

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
1649261850 Jeffrey M Clark Dentist 1938 Lyda Ave, Bowling Green, KY 42104-3326 2005-11-04
1841282027 Brian M O'neill Dentist 970 W Wooster St, Ste 126, Bowling Green, OH 43402-2643 2005-08-16
1891843504 Jerry E Cohron Dentist 1938 Lyda Ave, Bowling Green, KY 42104-3326 2007-01-08
1982696175 Oral & Maxillofacial Surgeons Inc Dentist 970 W Wooster St, Suite 126, Bowling Green, OH 43402-2643 2005-08-16

Providers in the same taxonomy and state

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
1588080303 Jia Ooi Dentist 550 S Jackson Street, Louisville, KY 40202 2014-03-17
1013258441 Adam Charles Marre Dentist Department of Surgical and Hospital, University of Louisville, Rm 148, Louisville, KY 40292-0001 2013-03-11
1538420195 Brent Fredrick Newby Dentist 2572 Sun Seeker Ct, Lexington, KY 40503-2981 2012-05-30
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
Find all providers with the same taxonomy

Competitor

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City BOWLING GREEN
Zip Code 42103

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Dataset Information

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.

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