Individual
RUSSELL L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5316 S WOODROW ST STE 200, SALT LAKE CITY, UT 84107-5838
(801) 747-1020
(801) 747-1020
Mailing address
5316 S WOODROW ST STE 200, SALT LAKE CITY, UT 84107-5838
(801) 747-1020
(801) 713-0609
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5646209-1205
UT
Other
Enumeration date
09/08/2005
Last updated
01/02/2019
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