Thorderson, Nels Wallace
Thorderson, Nels Wallace is an individual health care provider with primary practice located at 499 S Gloster St Ste G1 , Tupelo MS 38801-5539. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Thorderson, Nels Wallace can be contacted via phone (662) 377-2663.Contact Information
Primary practice address
499 S Gloster St Ste G1
Tupelo MS 38801-5539
Phone: (662) 377-2663
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Foot and Ankle Surgery | 207XX0004X | 18527 | Mississippi |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 18527 | Mississippi |
Profile Details
| NPI number | 1740250331 |
|---|---|
| LBN Legal business name | Thorderson, Nels Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Jan 26th, 2023 - about 2 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 | 1740250331 | NPPES |
| Mississippi | MEDICAID | 01573566 |
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