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Individual

JEFFREY C NEILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1400 BRYAN DR, SUITE 304, DURANT, OK 74701-2156
(580) 931-2278
(580) 931-2274
Mailing address
1400 BRYAN DR, STE 300, DURANT, OK 74701-2158
(580) 931-2278
(580) 931-2274

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G8932
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100113510A
OK
05
1027849-01
TX
05
117301001
AR
Enumeration date
07/19/2005
Last updated
09/03/2020
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