Individual
DR. WAYNE K. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 NE 27TH ST STE 100, BEND, OR 97701-7728
(541) 313-8111
(541) 313-8112
Mailing address
1550 NE 27TH ST STE 110, BEND, OR 97701-7728
(541) 313-8111
(541) 313-8112
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD161330
OR
208D00000X
General Practice Physician
N1798
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500659802
—
OR
01
—
DPS F0163850
TEXAS DPS NUMBER
TX
01
—
MD161330
OREGON MEDICAL LISCENSE
OR
01
—
N1798
TEXAS MEDICAL LISCENSE
TX
01
—
P01229162
MEDICARE RAILROAD
OR
Enumeration date
06/13/2007
Last updated
09/17/2020
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