Alan S. Nelson D.o. Pc | |
1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 | |
(208) 878-8817 | |
Not Available |
Full Name | Alan S. Nelson D.o. Pc |
---|---|
Speciality | Family Medicine |
Location | 1404 Pomerelle Ave., Burley, Idaho |
Authorized Official Name and Position | Alan S. Nelson (PHYSICIAN/OWNER) |
Authorized Official Contact | 2088788817 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Alan S. Nelson D.o. Pc 1404 Pomerelle Ave Ste A2 Burley ID 83318-2013 Ph: (208) 878-8817 | Alan S. Nelson D.o. Pc 1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 Ph: (208) 878-8817 |
NPI Number | 1184993586 |
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Provider Enumeration Date | 12/14/2011 |
Last Update Date | 12/04/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184993586 | NPI | - | NPPES |
804255700 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | O143 (Idaho) | Primary |
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