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NPI Code Detail

MEDICARE: DR. KIPER CECIL NELSON M.D.

MEDICARE: DR. KIPER CECIL 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
1207W00000XOphthalmology Physician16844MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2512I180022OTHERMSMEDICARE PTAN FOR SOUTHERN EYE PHYSICIAN'S CENTER LLC
3512I180023OTHERMSMEDICARE PTAN FOR SOUTHERN EYE SURGERY CENTER LLC

Other Identifiers

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

General Provider Information

NPI Number : 1548263312
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIPER CECIL NELSON M.D.
Provider Business Mailing Address
First Line : 1420 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-3107
Country : US
Telephone Number : 601-264-3937
Fax Number : 601-264-5930
Provider Business Practice Location Address
First Line : 1420 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-3107
Country : US
Telephone Number : 601-264-3937
Fax Number : 601-264-5930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 01/06/2009

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