Individual provider · Type 1 NPI

Nicole Poythress Waters, DO, PhD

Family Medicine Physician · Carrier Mills, IL

NPI number 1407416308 Active

Practice location

7211 US 45 S
Carrier Mills, IL 62917-1305

Fax (618) 294-8247

Mailing address

PO Box 155
Christopher, IL 62822-0155

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000X036157809 (IL)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4 other providers at this address

About NPI 1407416308

Nicole Poythress Waters, DO, PhD's National Provider Identifier is 1407416308, issued on Jun 13, 2019. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Carrier Mills, IL. The record was last updated on Feb 6, 2026.