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Individual

MR. CHRISTOPHER LEE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
42 BUSINESS CENTRE DR, SUITE 308, MIRAMAR BEACH, FL 32550-6920
(850) 460-8778
(850) 460-8779
Mailing address
10301 CHAMPION FARMS DR, LOUISVILLE, KY 40241-6129
(502) 423-1021
(502) 423-1416

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
200201130
NC
208VP0014X
Interventional Pain Medicine Physician
Primary
37667
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1329F
BLUE CROSS BLUE SHIELD NORTH CAROLINA
NC
01
37667
MEDICAL LICENSE
KY
05
64065196
KY
01
ME 123663
FL LICENSE
FL
Enumeration date
09/14/2005
Last updated
09/10/2015
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