Organization
HUNTER B NELSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUNTER B NELSON JR. MD (PRESIDENT)
(251) 544-1926
Entity
Organization
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 621-5088
(662) 614-3299
Mailing address
PO BOX 9218, MOBILE, AL 36691-0218
(251) 544-1926
(251) 460-2846
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15688
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000891228B
GA MEDICAID
GA
01
—
15688
MEDICAL LICENSE
MS
01
—
30BDJTQ
GA MEDICARE
GA
Enumeration date
12/15/2009
Last updated
07/15/2010
Update your record
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