Provider Demographics
NPI:1649444647
Name:NELSON, JOHN R (VMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:NELSON
Suffix:
Gender:M
Credentials:VMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6453
Mailing Address - Country:US
Mailing Address - Phone:973-538-5414
Mailing Address - Fax:973-538-0003
Practice Address - Street 1:467 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6453
Practice Address - Country:US
Practice Address - Phone:973-538-5414
Practice Address - Fax:973-538-0003
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00164900174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian