Provider Demographics
NPI:1033144647
Name:MELSON, MARK R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:MELSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:108 BRAVO BLVD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3412
Mailing Address - Country:US
Mailing Address - Phone:270-651-2181
Mailing Address - Fax:270-651-2183
Practice Address - Street 1:4306 HARDING PIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2205
Practice Address - Country:US
Practice Address - Phone:615-297-5798
Practice Address - Fax:615-383-6646
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2017-06-08
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Provider Licenses
StateLicense IDTaxonomies
TNMD43691207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology