MEDICARE: BARRY M. NELSON DO

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	207P00000X	Emergency Medicine Physician	20A8398	CA
2	207P00000X	Emergency Medicine Physician	31285	CO

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	:	1285742965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY M. NELSON DO

Provider Business Mailing Address
First Line	:	P.O. BOX 12020
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92685-2020
Country	:	US
Telephone Number	:	888-556-5619
Fax Number	:

Provider Business Practice Location Address
First Line	:	9330 S UNIVERSITY BLVD
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5065
Country	:	US
Telephone Number	:	303-758-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	06/04/2009

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Directions to “ BARRY M. NELSON DO” Practice Location

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