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General NPI Number Information
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NPI Number | 1144421876
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Entity Type | Individual
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Provider Name | JESSE W NEELEY DO
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1630 E PRIMROSE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7929
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Country | US
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Telephone | 417-885-4580
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 WOODSTEAD CT STE 208
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1480
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Country | US
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Telephone | 877-749-7428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 2018039152
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2018039152
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | N3935
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License Number State | TX
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