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NPI Code Detail

MEDICARE: STEPHEN B. NELSON M.D.

MEDICARE:   STEPHEN B. NELSON  M.D.
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
1207P00000XEmergency Medicine PhysicianC-6140AR
2207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianC-6140AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
353897OTHERARBLUECROSS BLUESHIELD

General Provider Information

NPI Number : 1447239702
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN B. NELSON M.D.
Provider Business Mailing Address
First Line : 3214 BUTTERFIELD EST
Second Line :
City : VAN BUREN
State : AR
Zip : 72956-8810
Country : US
Telephone Number : 479-926-1616
Fax Number : 479-262-6677
Provider Business Practice Location Address
First Line : 7301 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4100
Country : US
Telephone Number : 479-314-6248
Fax Number : 479-314-6159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 02/27/2020

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Directions to “ STEPHEN B. NELSON M.D.” Practice Location

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