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General NPI Number Information
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NPI Number | 1083946362
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Entity Type | Organization
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Legal Business Name | L. NEAL MCCAIN, M.D, LTD.
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 305 W JACKSON ST SUITE 302
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City | CARBONDALE
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State | IL
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Zip | 62901-1474
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Country | US
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Telephone | 618-529-1770
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Fax | 618-529-1777
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | CARBONDALE
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State | IL
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Zip | 62903-1507
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Country | US
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Telephone | 618-529-1770
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Fax | 618-529-1777
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Authorized Official
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Title or Position | PRESIDENT
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Name | L NEAL MCCAIN
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Credential | M.D.
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Telephone | 618-529-1770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036054813
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License Number State | IL
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