Individual
DR. PHIL OTIS NELSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
146 RIDGE DR, JACKSON, MS 39216-4109
(601) 982-5793
(601) 984-3631
Mailing address
146 RIDGE DR, JACKSON, MS 39216-4109
(601) 982-5793
(601) 984-3631
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04082
MS
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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