Provider Demographics
NPI:1316020704
Name:NIELSEN, JAMISON SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMISON
Middle Name:SCOTT
Last Name:NIELSEN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
Mailing Address - City:TAMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2460
Mailing Address - Fax:808-433-1558
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
Practice Address - City:TAMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-2460
Practice Address - Fax:808-433-1558
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HIDOS-1130208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery