Provider Demographics
NPI:1497933154
Name:NELSON, WILLIAM D (NMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:NELSON
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 E PINNACLE PEAK RD LOT 409
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8130
Mailing Address - Country:US
Mailing Address - Phone:602-692-4626
Mailing Address - Fax:480-418-3637
Practice Address - Street 1:7320 E DEER VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7453
Practice Address - Country:US
Practice Address - Phone:602-692-4626
Practice Address - Fax:418-418-3637
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-744208D00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice