Provider Demographics
NPI:1538113352
Name:NELSON, BARBARA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4724 NICKLESVILLE RD NE
Mailing Address - Street 2:
Mailing Address - City:RESACA
Mailing Address - State:GA
Mailing Address - Zip Code:30735
Mailing Address - Country:US
Mailing Address - Phone:706-264-3921
Mailing Address - Fax:706-625-6990
Practice Address - Street 1:105 WILLOWBROOK WAY SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-1404
Practice Address - Country:US
Practice Address - Phone:706-625-6999
Practice Address - Fax:706-625-6990
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA054628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF92118Medicare UPIN
F92118Medicare UPIN