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Individual

DR. MARK NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
(865) 541-2787
Mailing address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
15357
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100024069
PHP TENNCARE
TN
05
3008471
TN
01
4087758
BLUE CROSS
TN
01
P00168918
TRAVELERS MEDICARE
TN
Enumeration date
03/09/2006
Last updated
07/27/2011
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