| Doctor Name: | DR. JOHN ANTHONY NANSON |
| NPI Number: | 1104018415 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 20112 |
| Business Practice Address: | 1607 E 33rd St Ellefson Free Clinic Des Moines, IA - 503172705 |
| Business Phone Number: | 5152667622 |
| Business Fax Number: | |
| Mailing Address: | 1190 S Sundown Rd, PRESCOTT |
| State: | AZ |
| Postal Code: | 863035105 |
| Phone Number: | 9287779155 |
| Fax Number: | 9287787618 |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 08/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |