Individual
KRISTOPHER NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4256, 304 SHORTER AVE NW #201, ROME, GA 30165
(706) 509-3300
Mailing address
16 ROUND ROCK CIR NE, ROME, GA 30161-9326
(770) 301-1278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94447
GA
390200000X
Student in an Organized Health Care Education/Training Program
12026
GA
Other
Enumeration date
06/16/2020
Last updated
03/01/2023
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