Individual
ALAN S. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
500 W FORT ST # 111, BOISE, ID 83702-4599
(208) 732-0959
Mailing address
500 W FORT ST # 111, BOISE, ID 83702-4599
(208) 732-0959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-143
ID
207Q00000X
Family Medicine Physician
O143
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804255700
—
ID
Enumeration date
10/19/2005
Last updated
02/25/2022
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