# CHRISTIAN D NILSON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417112715
- **Authorized official:** DR. CHRISTIAN D NILSON MD (PRESIDENT)
- **Authorized official phone:** (435) 752-2020

## Contact information

- **Practice address:** 550 E 1400 N STE P, LOGAN, UT 84341-2450
- **Practice address phone:** (435) 752-2020
- **Practice address fax:** (435) 752-5475
- **Mailing address:** 550 E 1400 N, STE T, LOGAN, UT 84341-2406
- **Mailing address phone:** (435) 752-2020
- **Mailing address fax:** (435) 752-5475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 69626121205 | UT | Yes |

## Other

- **Enumeration date:** 07/25/2008
- **Last updated:** 08/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 08111972 | OWNERS DOB | UT |