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Individual

DR. DANIEL ANTHONY NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-3636
Mailing address
PO BOX 428, 625 EAST BROADWAY, JACKSON, WY 83001-0428
(307) 733-3636

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8910A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134940600
WY
Enumeration date
07/01/2009
Last updated
02/17/2021
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