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General NPI Number Information
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NPI Number | 1609870344
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Entity Type | Individual
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Provider Name | JOSHUA COOK NELSON D.O
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 1916 TAMARACK RD
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City | NEWARK
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State | OH
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Zip | 43055-2303
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Country | US
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Telephone | 740-522-6110
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Fax | 740-522-0126
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Provider Business Mailing Address
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Address Line | 3828 RACCOON VALLEY RD
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City | ALEXANDRIA
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State | OH
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Zip | 43001-9744
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Country | US
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Telephone | 740-587-1895
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 34007237N
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34007237
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License Number State | OH
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