Individual
DR. I. WILLIAM NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD,PC
Contact information
Practice address
556 E 4020 N, PROVO, UT 84604-5149
(801) 225-5881
(801) 434-7067
Mailing address
556 E 4020 N, PROVO, UT 84604-5149
(801) 225-5881
(801) 434-7067
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1526791205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1526791205
UTAH STATE LICENSE
UT
Enumeration date
07/27/2006
Last updated
03/30/2009
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