Individual
DAVID LEROY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1825 COUNTRY CLUB RD, STOUGHTON, WI 53589-3219
(608) 873-6077
Mailing address
1825 COUNTRY CLUB RD, STOUGHTON, WI 53589-3219
(608) 873-6077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15668
WI
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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