Individual
JOHN TRAVIS NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
108 PROMINENCE CT STE 200, DAWSONVILLE, GA 30534-6340
(770) 219-8420
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
85856
GA
207QS0010X
Sports Medicine (Family Medicine) Physician
82130
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2016
Last updated
01/15/2021
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