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Individual

JASON T NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA

Contact information

Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(678) 514-1991
(678) 514-1992
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
2010029842
MO
367H00000X
Anesthesiologist Assistant
Primary
GA

Other

Enumeration date
09/03/2010
Last updated
08/02/2016
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