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Individual

DONALD R NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
104 FAIRVIEW PARK DR, DUBLIN, GA 31021
(478) 272-1366
(478) 277-1922
Mailing address
PO BOX 1528, DUBLIN, GA 31040-1528
(478) 272-1366
(478) 277-1922

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
024847
GA
207RI0200X
Infectious Disease Physician
024847
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000290089C
GA
01
1459269
UNITED HEALTHCARE
GA
01
5110781
FIRST HEALTH
GA
01
52048975-002
BCBS
GA
01
5839179
AETNA
GA
01
P00688224
RR MEDICARE
GA
Enumeration date
01/05/2006
Last updated
05/04/2021
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