Provider Demographics
NPI:1295521540
Name:HARVEY AND NICHOLS RADCLIFF PLLC
Entity type:Organization
Organization Name:HARVEY AND NICHOLS RADCLIFF PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-505-5066
Mailing Address - Street 1:1602 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-5458
Mailing Address - Country:US
Mailing Address - Phone:270-505-5066
Mailing Address - Fax:
Practice Address - Street 1:299 W LINCOLN TRAIL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-3306
Practice Address - Country:US
Practice Address - Phone:270-352-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center