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General NPI Number Information
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NPI Number | 1962680108
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Entity Type | Organization
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Legal Business Name | DONALD R NELSON MD PC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 1945 MESQUITE AVE STE A
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5889
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Country | US
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Telephone | 928-855-4128
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Fax | 928-855-7539
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Provider Business Mailing Address
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Address Line | 1945 MESQUITE AVE STE A
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5889
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Country | US
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Telephone | 928-855-4128
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Fax | 928-855-7539
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ARLUENE RUTH LANGEJANS
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Credential |
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Telephone | 928-855-4128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 05491
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License Number State | AZ
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