| Alan S. Nelson D.O. PC | |
|
1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 | |
| (208) 878-8817 | |
| Not Available |
| Full Name | Alan S. Nelson D.O. PC |
|---|---|
| Speciality | Family Medicine |
| Location | 1404 Pomerelle Ave., Burley, Idaho |
| Authorized Official Name and Position | Alan S. Nelson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2088788817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan S. Nelson D.O. PC 1404 Pomerelle Ave Ste A2 Burley ID 83318-2013 Ph: (208) 878-8817 | Alan S. Nelson D.O. PC 1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 Ph: (208) 878-8817 |
| NPI Number | 1184993586 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 12/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184993586 | NPI | - | NPPES |
| 804255700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O143 (Idaho) | Primary |
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