Individual
MR. MARK GEORGE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
4015 HWY I 49 SOUTH SERVICE RD, OPELOUSAS, LA 70570
(337) 942-6503
(337) 942-8831
Mailing address
4015 HWY I 49 SOUTH SERVICE RD, OPELOUSAS, LA 70570
(337) 942-6503
(337) 942-8831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
LA10059
LA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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