Individual
SHAWN KEITH NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3183 W STATE ST, SUITE 1201, BRISTOL, TN 37620-1712
(423) 764-0987
(423) 652-2512
Mailing address
3183 W STATE ST, SUITE 1201, BRISTOL, TN 37620-1712
(423) 764-0987
(423) 652-2512
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
34012
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007101147
—
VA
05
—
010365040
—
VA
05
—
3152685
—
TN
05
—
3854328
—
TN
Enumeration date
08/26/2005
Last updated
07/20/2012
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