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General NPI Number Information
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NPI Number | 1003006065
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Entity Type | Organization
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Legal Business Name | JOHN F NIELSEN M D FAMILY MEDICINE PA
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 702 DAVIS ST STE 4
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City | CARTHAGE
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State | TX
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Zip | 75633-1461
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Country | US
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Telephone | 903-694-4991
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Fax | 903-694-4995
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Provider Business Mailing Address
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Address Line | 702 DAVIS ST STE 4
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City | CARTHAGE
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State | TX
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Zip | 75633-1461
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Country | US
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Telephone | 903-694-4991
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Fax | 903-694-4995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN FRANCIS NIELSEN
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Credential | M.D
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Telephone | 903-694-4991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J8333
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License Number State | TX
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