| Doctor Name: | BRENT V. NELSON |
| NPI Number: | 1023084902 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | DO407 |
| Business Practice Address: | 1650 Cochrane Cir Adolescent Medicine Usa Meddac, Each, Fort Carson, CO - 809134603 |
| Business Phone Number: | 7195267226 |
| Business Fax Number: | |
| Mailing Address: | 630 Maroonglen Ct, COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809066805 |
| Phone Number: | 7195762745 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | DO407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |