Basic Information
| Provider Information | |||||||||
| NPI: | 1992784359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEAL | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 519 E LAUCHWOOD DR | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102761150 | ||||||||
| FaxNumber: | 9102771966 | ||||||||
| Practice Location | |||||||||
| Address1: | 519 LAUCHWOOD DRIVE | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102761150 | ||||||||
| FaxNumber: | 9102771966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 03/21/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 22313 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.