Individual
MATTHEW TANNER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1201 PLEASANT VALLEY RD, OWENSBORO, KY 42303-9811
(270) 417-2000
Mailing address
3007 AUTUMN LAKE CV, OWENSBORO, KY 42303-4464
(270) 625-8178
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04493
KY
207P00000X
Emergency Medicine Physician
Primary
OS019090
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2015
Last updated
11/27/2019
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