Basic Information
| Provider Information | |||||||||
| NPI: | 1922129378 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DONALD R NEEL, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2816 VEACH RD | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | OWENSBORO | ||||||||
| State: | KY | ||||||||
| PostalCode: | 423036295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2709269821 | ||||||||
| FaxNumber: | 2709269867 | ||||||||
| Practice Location | |||||||||
| Address1: | 2816 VEACH RD | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | OWENSBORO | ||||||||
| State: | KY | ||||||||
| PostalCode: | 423036295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2709269821 | ||||||||
| FaxNumber: | 2709269867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | NEEL | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2709269821 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 13868 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 64138688 | 05 | KY | MEDICAID |