Provider Demographics
NPI:1851089106
Name:NELSON, THOMAS BENJAMIN (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:BENJAMIN
Last Name:NELSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-6540
Mailing Address - Country:US
Mailing Address - Phone:919-906-3806
Mailing Address - Fax:
Practice Address - Street 1:351 VALLEY HEALTH WAY STE 300
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6480
Practice Address - Country:US
Practice Address - Phone:540-631-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program