Healthcare Provider Details

I. General information

NPI: 1972660827
Provider Name (Legal Business Name): ARTIE C NELSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 05/20/2008
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 Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number15531
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier051082808
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBCBS
# 2
Identifier000082808
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: