Healthcare Provider Details

I. General information

NPI: 1316183528
Provider Name (Legal Business Name): STEVEN L. NEAL, MD, FACS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 SW DORION AVE
PENDLETON OR
97801-2039
US

IV. Provider business mailing address

702 SW DORION AVE
PENDLETON OR
97801-2039
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-4160
  • Fax: 541-276-2860
Mailing address:
  • Phone: 541-276-4160
  • Fax: 541-276-2860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number15111
License Number StateOR

VIII. Authorized Official

Name: STEVEN L NEAL
Title or Position: OWNER
Credential: MD
Phone: 541-276-4160