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Individual

RICK F NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.,PHD

Contact information

Practice address
705 RILEY HOSPITAL DR, SUITE 0860, INDIANAPOLIS, IN 46202-5109
(317) 278-1259
(317) 278-3743
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01074249A
IN
207Y00000X
Otolaryngology Physician
R8142
IA
207YX0901X
Otology & Neurotology Physician
Primary
01074249A
IN
207YX0901X
Otology & Neurotology Physician
40382
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000891707
ANTHEM PTAN
IN
01
1102379697
ANTHEM PTAN
IN
05
201242430
IN
Enumeration date
07/16/2007
Last updated
04/11/2025
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