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NPI Code Detail

MEDICARE: TIMOTHY W MCNEELY M.D.

MEDICARE: TIMOTHY W MCNEELY 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician22735AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1481277597OTHERALTAX ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
351514294OTHERALBLUE CROSS BLUE SHIELD AL

General Provider Information

NPI Number : 1184613127
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY W MCNEELY M.D.
Provider Business Mailing Address
First Line : PO BOX 1410
Second Line :
City : DOTHAN
State : AL
Zip : 36302-1410
Country : US
Telephone Number : 334-793-0010
Fax Number : 334-677-6791
Provider Business Practice Location Address
First Line : 4370 W MAIN ST
Second Line :
City : DOTHAN
State : AL
Zip : 36305-1056
Country : US
Telephone Number : 334-793-5000
Fax Number : 334-677-6791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 03/10/2011

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