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General NPI Number Information
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NPI Number | 1629437223
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Entity Type | Individual
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Provider Name | ROMON NEELY MD
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Gender | Male
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 300 TWINING ST BLDG 760
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City | MAXWELL AFB
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State | AL
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Zip | 36112-6027
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Country | US
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Telephone | 334-953-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 3551 ROGER BROOKE DR
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City | FT SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 386-453-3626
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 30230
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 30230
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116033379
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0116033379
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 51045
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License Number State | AL
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