Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | LL25434 | SC |
NPI | 1942384433 |
---|---|
Provider Name | Dr. Jeffrey Gardner Neal |
First Address | Abingdon, VA 29403-6645 |
Second Address | Abingdon, VA 24210-2836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 19/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1942384433 | (05) | VA |
303202 | ANTHEM (01) | VA |