Provider Demographics
NPI:1972660827
Name:NELSON, ARTIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTIE
Middle Name:C
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 LORNA RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3005
Mailing Address - Country:US
Mailing Address - Phone:205-985-4939
Mailing Address - Fax:205-985-4431
Practice Address - Street 1:3825 LORNA RD
Practice Address - Street 2:SUITE 240
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-3005
Practice Address - Country:US
Practice Address - Phone:205-985-4939
Practice Address - Fax:205-985-4431
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL155312084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051082808OtherBCBS
AL000082808Medicaid
AL051553342Medicare PIN
AL051082808OtherBCBS