Organization
TRI-STATE PULMONARY ASSOC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT R NELSON MD (PRESIDENT)
(606) 329-1185
Entity
Organization
Contact information
Practice address
613 23RD ST, MEDICAL PLAZA B SUITE G30, ASHLAND, KY 41101-2878
(606) 329-1185
(606) 324-0585
Mailing address
PO BOX 1380, 613 23RD STREED MEDICAL PLAZA B SUITE G30, ASHLAND, KY 41105-1380
(606) 329-1185
(606) 324-0585
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0320
ANTHEM
KY
01
—
2588632
OMA
KY
05
—
65940272
—
KY
Enumeration date
09/19/2006
Last updated
11/03/2009
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