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NPI Code Detail

MEDICARE: KERRY M MCNEAL PHARM.D.

MEDICARE: KERRY M MCNEAL PHARM.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
1183500000XPharmacist19961LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119961OTHERLALOUISIANA BOARD OF PHARMACY

General Provider Information

NPI Number : 1386078574
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY M MCNEAL PHARM.D.
Provider Business Mailing Address
First Line : 1009 HIGHWAY 453
Second Line :
City : MARKSVILLE
State : LA
Zip : 71351-4980
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1422 MACARTHUR DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-4022
Country : US
Telephone Number : 318-442-0512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2013
Last Update Date : 08/25/2013

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