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General NPI Number Information
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NPI Number | 1487700878
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Entity Type | Organization
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Legal Business Name | GLENN E NELSON DPM LLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2308 N ROSEMONT BLVD
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City | TUCSON
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State | AZ
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Zip | 85712-2139
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Country | US
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Telephone | 520-886-1172
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Fax | 520-290-8894
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Provider Business Mailing Address
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Address Line | 2308 N ROSEMONT BLVD
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City | TUCSON
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State | AZ
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Zip | 85712-2139
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Country | US
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Telephone | 520-886-1172
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Fax | 520-290-8894
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Authorized Official
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Title or Position | DOCTOR
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Name | DAVID HATCH
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Credential | DPM
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Telephone | 520-886-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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