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General NPI Number Information
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NPI Number | 1881873685
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Entity Type | Organization
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Legal Business Name | RICHARD G MCNEELY DO LLC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 1108 VESTER AVE
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City | SPRINGFIELD
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State | OH
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Zip | 45503
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Country | US
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Telephone | 937-399-7100
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Fax | 937-399-7355
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Provider Business Mailing Address
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Address Line | 1108 VESTER AVE
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City | SPRINGFIELD
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State | OH
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Zip | 45503
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Country | US
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Telephone | 937-399-7100
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Fax | 937-399-7355
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD G MCNEELY
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Credential | DO
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Telephone | 937-399-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34004683
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License Number State | OH
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