Healthcare Provider Details

I. General information

NPI: 1366692287
Provider Name (Legal Business Name): JAMES JOHN MACNEAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2008
Last Update Date: 09/29/2026
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

IV. Provider business mailing address

1405 MILL ST
NEW LONDON WI
54961-2155
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-5511
  • Fax: 715-387-5240
Mailing address:
  • Phone: 920-531-2030
  • Fax: 920-531-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number56837
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number56837-21
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number036129701
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: