Individual
TANNER COLE NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(018) 156-7006
Mailing address
18575 OLD HIGHWAY 49, SAUCIER, MS 39574-8419
(228) 243-9630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1750086419
MS
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
07/24/2023
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