Individual
DR. DEAN ALLAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
267 N CANYON DR, GOODING, ID 83330-5500
(208) 934-4446
(208) 934-4442
Mailing address
267 N CANYON DR, GOODING, ID 83330-5500
(208) 934-4446
(208) 934-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00352
ID
207P00000X
Emergency Medicine Physician
10491
MT
207Q00000X
Family Medicine Physician
Primary
00352
ID
207Q00000X
Family Medicine Physician
10491
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000096575
BLUE CROSS BS
MT
05
—
0069207
—
MT
05
—
807560000
—
ID
Enumeration date
08/20/2006
Last updated
03/15/2017
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