Basic Information
Provider Information
NPI: 1093834442
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEEL
FirstName: DUSTIN
MiddleName: RYAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2310 HOLMES ST
Address2: STE 800
City: KANSAS CITY
State: MO
PostalCode: 641082602
CountryCode: US
TelephoneNumber: 8162182523
FaxNumber: 8164217379
Practice Location
Address1: 2301 HOLMES ST
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641082640
CountryCode: US
TelephoneNumber: 8164040099
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2007
LastUpdateDate: 10/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X2013021801MOY Allopathic & Osteopathic PhysiciansSurgery 
2086S0127X2013021801MON Allopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
2086S0102X2013021801MON Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care

No ID Information.


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