Healthcare Provider Details

I. General information

NPI: 1861576878
Provider Name (Legal Business Name): JAMES DIAMOND MCNEVIN MD & D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CLINIC DR FL 5
MADISONVILLE KY
42431-1661
US

IV. Provider business mailing address

200 CLINIC DR FL 5
MADISONVILLE KY
42431-1661
US

V. Phone/Fax

Practice location:
  • Phone: 270-825-6680
  • Fax: 270-825-7266
Mailing address:
  • Phone: 270-825-6680
  • Fax: 270-825-7266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3876
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57021
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: