Provider Demographics
NPI:1427036813
Name:NELSON, DONALD R (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1528
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31040-1528
Mailing Address - Country:US
Mailing Address - Phone:478-272-1366
Mailing Address - Fax:478-277-1922
Practice Address - Street 1:104 FAIRVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021
Practice Address - Country:US
Practice Address - Phone:478-272-1366
Practice Address - Fax:478-277-1922
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA024847207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1459269OtherUNITED HEALTHCARE
GA52048975-002OtherBCBS
GA5839179OtherAETNA
GA000290089CMedicaid
GA5110781OtherFIRST HEALTH
GAP00688224OtherRR MEDICARE
GAP00688224OtherRR MEDICARE
GAD42196Medicare UPIN