MEDICARE: NELSON MEDICAL CONSULTING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063596757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NELSON MEDICAL CONSULTING, INC.

Provider Business Mailing Address
First Line	:	907 E SUNFLOWER RD
Second Line	:	STE 101
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2830
Country	:	US
Telephone Number	:	662-721-1399
Fax Number	:	662-721-1380

Provider Business Practice Location Address
First Line	:	907 E SUNFLOWER RD
Second Line	:	STE 101
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2830
Country	:	US
Telephone Number	:	662-721-1399
Fax Number	:	662-721-1380

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT NELSON
Credential	:	MD
Telephone Number	:	662-721-1399

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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