Individual
JOHN CLAYTON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1146 EVELYN GANDY PKWY, PETAL, MS 39465-3947
(601) 584-4309
Mailing address
1146 EVELYN GANDY PKWY, PETAL, MS 39465-3947
(601) 584-4309
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
08024
MS
207Q00000X
Family Medicine Physician
Primary
08024
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019517
—
MS
Enumeration date
06/29/2006
Last updated
07/27/2022
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