Healthcare Provider Details

I. General information

NPI: 1851421218
Provider Name (Legal Business Name): ARTIE NELSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 LORNA RD SUITE 240
BIRMINGHAM AL
35244-3005
US

IV. Provider business mailing address

3825 LORNA RD SUITE 240
BIRMINGHAM AL
35244-3005
US

V. Phone/Fax

Practice location:
  • Phone: 205-985-4939
  • Fax: 205-985-4431
Mailing address:
  • Phone: 205-985-4939
  • Fax: 205-985-4431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number15531
License Number StateAL

VIII. Authorized Official

Name: ARTIE CORTEZ NELSON
Title or Position: OWNER
Credential: MD
Phone: 205-985-4939