Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Robert S Nickolisen, MD

Individual provider Specialist · NPI 1487692125

Robert S Nickolisen, MD is a Specialist in Parker, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

601 W Riverside Dr Suites 3 And 4
Parker, AZ 85344-5119
Phone: (602) 377-5900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 15301 (AZ)

Record details

NPI number1487692125
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 3, 2006
Last updated in NPPESOctober 27, 2010
Mailing address2485 Stroke Dr, Lake Havasu City, AZ 86406-7622

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