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NPI Code Detail

MEDICARE: HUNTER B NELSON JR. M.D.

MEDICARE: HUNTER B NELSON JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician21200AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
351531624OTHERALBC/BS OF AL

General Provider Information

NPI Number : 1134160039
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUNTER B NELSON JR. M.D.
Provider Business Mailing Address
First Line : P.O. BOX 9218
Second Line :
City : MOBILE
State : AL
Zip : 36691-0218
Country : US
Telephone Number : 251-460-0326
Fax Number : 251-460-2846
Provider Business Practice Location Address
First Line : 1970 HOSPITAL DRIVE
Second Line :
City : CLARKSDALE
State : MS
Zip : 38614-7202
Country : US
Telephone Number : 251-544-1926
Fax Number : 251-460-2846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 10/25/2018

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