# GLENN E NELSON DPM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sonoran Foot and Ankle Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487700878
- **Authorized official:** DAVID HATCH DPM (DOCTOR)
- **Authorized official phone:** (520) 886-1176

## Contact information

- **Practice address:** 2308 N ROSEMONT BLVD, TUCSON, AZ 85712-2139
- **Practice address phone:** (520) 886-1172
- **Practice address fax:** (520) 290-8894
- **Mailing address:** 2308 N ROSEMONT BLVD, TUCSON, AZ 85712-2139
- **Mailing address phone:** (520) 886-1172
- **Mailing address fax:** (520) 290-8894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 10/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 701004 | — | AZ |
| 01 | — | DC9300 | RAILROAD MEDICARE | AZ |