Individual
DR. ROGER E NELLANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1739 E BEVERLY AVE, SUITE 101, KINGMAN, AZ 86409-3593
(928) 681-8686
(928) 681-8690
Mailing address
1739 BEVERLY AVE, SUITE 101, KINGMAN, AZ 86409
(928) 681-8686
(928) 681-8690
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
15152
WA
208800000X
Urology Physician
33271
AZ
208800000X
Urology Physician
Primary
MD28212
OR
Other
Enumeration date
10/10/2006
Last updated
03/26/2015
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