Individual
DR. GARY REX NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1000
Mailing address
127 S 500 E, SALT LAKE CITY, UT 84102-1959
(801) 587-6336
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8134458-1205
UT
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
8134458-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2010
Last updated
11/08/2021
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