Individual
DARRICK P. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1007 N POPE ST, SILVER CITY, NM 88061-5161
(575) 388-1511
(575) 388-3465
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L5071
TX
207Q00000X
Family Medicine Physician
Primary
MD2010-0242
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156494004
—
TX
05
—
72135361
—
NM
01
—
8AQ389
BCBS
TX
01
—
NMA100969
MEDICARE PTAN
NM
Enumeration date
06/28/2005
Last updated
09/02/2014
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