Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 55881 | TN |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 55881 | TN |
NPI | 1134539075 |
---|---|
Provider Name | Jeffrey Scott Nelson |
First Address | Memphis, TN 38119-0213 |
Second Address | Memphis, TN 38119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2014 |
Last Update Date | 07/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00477876 | (05) | MS |
1134539075 | (05) | MO |
230370001 | (05) | AR |
Q038577 | (05) | TN |