Individual
ROBERT NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 W COUNTRY CLUB RD, SUITE #205, ROSWELL, NM 88201-5205
(575) 622-7593
(575) 622-5538
Mailing address
405 W COUNTRY CLUB RD, C/O MSO ADMINISTRATION, ROSWELL, NM 88201-5209
(575) 622-7593
(575) 622-5538
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00029981
WA
208800000X
Urology Physician
MD2013-0026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222357
L&I
WA
05
—
8141012
—
WA
01
—
8944748
CV
WA
Enumeration date
09/15/2005
Last updated
05/17/2026
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