Individual
THOMAS NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 E MAIN ST, RUTHERFORD, TN 38369-9711
(731) 665-7741
Mailing address
17 QUAIL RDG, TRENTON, TN 38382-4000
(731) 855-4283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29728
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157873
UNISON PROVIDER NUMBER
TN
01
—
32094
TLC PROVIDER NUMBER
TN
05
—
3898024
—
TN
01
—
4088427
BCBS PROVIDER NUMBER
TN
01
—
7725301
AETNA PROVIDER NUMBER
TN
01
—
8081169
CIGNA HEALTHCARE PROVIDER
TN
Enumeration date
05/20/2006
Last updated
07/12/2024
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