Provider Demographics
NPI:1104874379
Name:NEAHRING, JAMES MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:NEAHRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 GATEWAY BLVD STE 2120
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:4007 GATEWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8947
Practice Address - Country:US
Practice Address - Phone:812-842-0907
Practice Address - Fax:812-490-7054
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042748A207RC0000X
KY31115207RC0000X
IL036-093986207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060028719OtherRR MCR
IN200030990Medicaid
000000042532OtherANTHEM
KY64877491Medicaid
ILL65355Medicare PIN
IN532500PMedicare PIN
KY0255513Medicare PIN
000000042532OtherANTHEM
KY0255513Medicare ID - Type UnspecifiedKY MCR