Healthcare Provider Details
I. General information
NPI: 1497784268
Provider Name (Legal Business Name): KENNETH F MCNEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 HOSPITAL DR
HURRICANE WV
25526-9202
US
IV. Provider business mailing address
PO BOX 3466
CHARLESTON WV
25334-3466
US
V. Phone/Fax
- Phone: 304-720-8816
- Fax: 904-494-6467
- Phone: 304-720-8816
- Fax: 904-494-6467
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 22388 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 25360 |
| License Number State | KY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 35079799M |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 16058 |
| License Number State | WV |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 35079799M |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 22388 |
| License Number State | SC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 25360 |
| License Number State | KY |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 16058 |
| License Number State | WV |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 16058 |
| License Number State | WV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: