Healthcare Provider Details

I. General information

NPI: 1205880077
Provider Name (Legal Business Name): STACEY LYNN NEAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE PATHOLOGY DEPT
ASHEVILLE NC
28801
US

IV. Provider business mailing address

PO BOX 419
SYLVA NC
28779-0419
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-0763
  • Fax:
Mailing address:
  • Phone: 828-366-1150
  • Fax: 828-586-8209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number33922
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number33922
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: