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Individual

DR. BRENT NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5040 N 15TH AVE, SUITE 202, PHOENIX, AZ 85015-3328
(602) 248-0123
(602) 248-8506
Mailing address
5040 N 15TH AVE, SUITE 202, PHOENIX, AZ 85015-3328
(602) 248-0123
(602) 248-8506

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4344
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
425247
AZ
Enumeration date
05/15/2008
Last updated
06/23/2010
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