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NPI Code Detail

MEDICARE: JAMES J.L. NEILL M.D.

MEDICARE: JAMES J.L. NEILL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2007028775MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1135570004OTHERMOMEDICARE PTAN
2P00631928OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013181601
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES J.L. NEILL M.D.
Provider Business Mailing Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1930 N BUSINESS ROUTE 5
Second Line : UNIT 1A
City : CAMDENTON
State : MO
Zip : 65020-2659
Country : US
Telephone Number : 573-346-5624
Fax Number : 573-346-1957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 07/13/2009

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Directions to “ JAMES J.L. NEILL M.D.” Practice Location

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