Individual
MR. NELSON PARKS DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
175 N MEDICAL DR RM 5001, SALT LAKE CITY, UT 84112-1103
(801) 581-2121
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
14206306-1205
UT
2084N0600X
Clinical Neurophysiology Physician
14206306-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
Other
Enumeration date
03/29/2021
Last updated
05/13/2026
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