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NPI 1174521082

NPI 1174521082 : WILLIAM M NIELSON DPM : FLORENCE, KY

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General NPI Number Information
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    NPI Number           |    1174521082
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM M NIELSON DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/13/2005
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    Last Update Date     |    09/06/2018
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Provider Practice Location Address
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    Address Line         |    7370 TURFWAY RD STE 302
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    City                 |    FLORENCE
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    State                |    KY
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    Zip                  |    41042
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    Country              |    US
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    Telephone            |    859-371-4020
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    Fax                  |    859-746-7464
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Provider Business Mailing Address
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    Address Line         |    PO BOX 635283 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45263-5283
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    Country              |    US
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    Telephone            |    859-212-0175
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    Fax                  |    859-441-3698
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213EP1101X
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    Taxonomy Name        |    Primary Podiatric Medicine Podiatrist
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    License Number       |    00165
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    License Number State |    KY
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