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Individual

DAVID LEE NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-8032
(318) 675-8775
Mailing address
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-8032
(318) 675-8775

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
021624
LA
207Q00000X
Family Medicine Physician
Primary
021624
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699179
LA
Enumeration date
07/17/2006
Last updated
07/15/2014
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