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Individual

DR. JAMES D NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.A.P.

Contact information

Practice address
149 WALNUT GROVE CHURCH RD, DAYTON, TN 37321-7925
(423) 775-5512
(423) 775-0155
Mailing address
149 WALNUT GROVE CHURCH RD, DAYTON, TN 37321-7925
(423) 775-5512
(423) 775-0155

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD0000015680
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10011360
PHP CARITEN
TN
05
3008582
TN
01
621654001
FEDERAL TAX ID
01
BCBS
37544
NE
01
TN0101
JOHN DEERE HEALTH
TN
Enumeration date
12/06/2006
Last updated
07/09/2007
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