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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740250331 NPPES
Mississippi MEDICAID 01573566

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