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General NPI Number Information
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NPI Number | 1861838922
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Entity Type | Individual
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Provider Name | MARK A. MACNEALY DO, JD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 8859 CINCINNATI DAYTON RD STE 102
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City | WEST CHESTER
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State | OH
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Zip | 45069-3193
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Country | US
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Telephone | 513-880-8448
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Fax | 402-279-8571
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Provider Business Mailing Address
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Address Line | 9378 S MASON MONTGOMERY RD STE 102
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City | MASON
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State | OH
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Zip | 45040-8827
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Country | US
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Telephone | 937-809-9091
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Fax | 402-279-8571
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 34.002617
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License Number State | OH
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