Individual
WILLIAM ORTAN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3550
(681) 342-3507
Mailing address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3550
(681) 342-3507
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01524
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WV0343B
MEDICARE PTAN
WV
Enumeration date
11/01/2010
Last updated
05/27/2014
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