Provider Demographics
NPI:1942591664
Name:NELSON, JACOB REED (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:REED
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2450 W HORIZON RIDGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2722
Mailing Address - Country:US
Mailing Address - Phone:702-990-0622
Mailing Address - Fax:702-938-1473
Practice Address - Street 1:2450 W HORIZON RIDGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2722
Practice Address - Country:US
Practice Address - Phone:702-990-0622
Practice Address - Fax:702-938-1473
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY276710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine