Provider Demographics
NPI:1417573874
Name:NELSON, COLBERT CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:COLBERT
Middle Name:CHARLES
Last Name:NELSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:101 REDTAIL DR STE C
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MO
Practice Address - Zip Code:65010-1140
Practice Address - Country:US
Practice Address - Phone:573-882-9060
Practice Address - Fax:573-657-3015
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023014189207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine