Nelson, Eric Reynold
Nelson, Eric Reynold is an individual health care provider with primary practice located at 3101 Clearwater Dr Suite A, Prescott AZ 86305-7180. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Nelson, Eric Reynold can be contacted via phone (928) 776-1004.Contact Information
Primary practice address
3101 Clearwater Dr Suite A
Prescott AZ 86305-7180
Phone: (928) 776-1004
Fax: (928) 776-1276
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 29418 | Arizona |
Profile Details
| NPI number | 1376541805 |
|---|---|
| LBN Legal business name | Nelson, Eric Reynold |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Dec 11th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376541805 | NPPES |
| Arizona | MEDICAID | 589286 |
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