Individual
JASON D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 HOSPITAL DR, SUITE 130, BOSSIER CITY, LA 71111-2385
(318) 212-7990
(318) 212-7995
Mailing address
2400 HOSPITAL DR, SUITE 130, BOSSIER CITY, LA 71111-2385
(318) 212-7990
(318) 212-7995
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
202992
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07858
—
LA
05
—
1078581
—
LA
Enumeration date
05/25/2007
Last updated
01/20/2012
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