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NPI Code Detail

MEDICARE: DR. JEFFREY L NEELY M.D.

MEDICARE: DR. JEFFREY L NEELY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician13568WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376516443
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY L NEELY M.D.
Provider Business Mailing Address
First Line : PO BOX 897
Second Line : 255 SCOTT AVENUE
City : MORGANTOWN
State : WV
Zip : 26507-0897
Country : US
Telephone Number : 304-293-7401
Fax Number : 304-293-6963
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DRIVE
Second Line : PHYSICIAN OFFICE CENTER
City : MORGANTOWN
State : WV
Zip : 26506
Country : US
Telephone Number : 304-598-4800
Fax Number : 304-293-6963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 07/08/2007

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