Provider Demographics
NPI:1639391402
Name:F. REX NIELSEN, MD, PC
Entity Type:Organization
Organization Name:F. REX NIELSEN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:F.
Authorized Official - Middle Name:REX
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-637-3098
Mailing Address - Street 1:280 N HOSPITAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4216
Mailing Address - Country:US
Mailing Address - Phone:435-637-3098
Mailing Address - Fax:435-637-8656
Practice Address - Street 1:280 N HOSPITAL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4216
Practice Address - Country:US
Practice Address - Phone:435-637-3098
Practice Address - Fax:435-637-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT94-272238-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1508811639OtherMY TYPE 1 NPI #
UT1508811639OtherMY TYPE 1 NPI #