Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 32650 | KY |
Y | 2080A0000X | Adolescent Medicine | 32650 | KY |
N | 2080P0208X | Pediatric Infectious Diseases | 32650 | KY |
NPI | 1164442240 |
---|---|
Provider Name | Christopher Thomas Nelson |
First Address | Lexington, KY 40503-2894 |
Second Address | Lexington, KY 40503-2894 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 23/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64326507 | (05) | KY |
G29498 | (02) |