MEDICARE: JAMES SIMEON ADAMS NEILL MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	08398	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01402418	OTHER	MS	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1912987819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SIMEON ADAMS NEILL MD

Provider Business Mailing Address
First Line	:	106 EASTHAVEN DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-2825
Country	:	US
Telephone Number	:	601-984-1530
Fax Number	:	601-984-1531

Provider Business Practice Location Address
First Line	:	106 EASTHAVEN DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-2825
Country	:	US
Telephone Number	:	601-984-1530
Fax Number	:	601-984-1531

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	09/06/2022

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