Provider Demographics
NPI:1235455056
Name:NELSON, JARED WYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:WYNN
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2771 OAKDALE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9747
Mailing Address - Country:US
Mailing Address - Phone:319-545-7310
Mailing Address - Fax:319-626-7314
Practice Address - Street 1:2769 HEARTLAND DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241
Practice Address - Country:US
Practice Address - Phone:319-545-7300
Practice Address - Fax:319-545-7314
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2021-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA389552085R0202X
PAMT1865572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology