Provider Demographics
NPI:1508197955
Name:JEFFREY J. NELSON M.D., P.C.
Entity type:Organization
Organization Name:JEFFREY J. NELSON M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-566-8304
Mailing Address - Street 1:3584 W 9000 S
Mailing Address - Street 2:SUITE 311
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5710
Mailing Address - Country:US
Mailing Address - Phone:801-566-8304
Mailing Address - Fax:801-566-8330
Practice Address - Street 1:3584 W 9000 S
Practice Address - Street 2:SUITE 311
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5710
Practice Address - Country:US
Practice Address - Phone:801-566-8304
Practice Address - Fax:801-566-8330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty