Provider Demographics
NPI:1154355642
Name:NEILL, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:NEILL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2470 FLOWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:877-554-4257
Mailing Address - Fax:601-983-2845
Practice Address - Street 1:2470 FLOWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:877-554-4257
Practice Address - Fax:601-983-2845
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS08399207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSB66106Medicare UPIN