Healthcare Provider Details

I. General information

NPI: 1164496568
Provider Name (Legal Business Name): JEFFREY S. NEAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WALLER AVE SUITE 100
LEXINGTON KY
40504-2931
US

IV. Provider business mailing address

330 WALLER AVE SUITE 100
LEXINGTON KY
40504-2931
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-7000
  • Fax: 859-255-4381
Mailing address:
  • Phone: 859-254-7000
  • Fax: 859-255-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number27998
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: