MEDICARE: DR. RODNEY E MCNEAL LP

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
1	103TC0700X	Clinical Psychologist	1277	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00868295	OTHER	KS	MEDICARE RR

Other Identifiers

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

General Provider Information

NPI Number	:	1295836427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY E MCNEAL LP

Provider Business Mailing Address
First Line	:	8014 STATE LINE RD STE 100
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66208-3712
Country	:	US
Telephone Number	:	913-432-2400
Fax Number	:	913-432-2401

Provider Business Practice Location Address
First Line	:	8014 STATE LINE RD
Second Line	:	STE 100
City	:	LEAWOOD
State	:	KS
Zip	:	66208-3723
Country	:	US
Telephone Number	:	913-432-2400
Fax Number	:	913-432-2401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	01/11/2019

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