Provider Demographics
NPI:1003908591
Name:NELSON, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7061 N WHITNEY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-299-0224
Mailing Address - Fax:559-299-4201
Practice Address - Street 1:7061 N WHITNEY
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-299-0224
Practice Address - Fax:559-299-4201
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-11-16
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Provider Licenses
StateLicense IDTaxonomies
CA00G504510207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E48742Medicare UPIN