Provider Demographics
NPI:1194060210
Name:MCNEILL, GEORGE (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:MCNEILL
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 1:6900 SW ATLANTA ST
Mailing Address - Street 2:BLDG 2, SUITE 120
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2513
Mailing Address - Country:US
Mailing Address - Phone:503-684-3988
Mailing Address - Fax:503-684-6077
Practice Address - Street 1:6900 SW ATLANTA ST
Practice Address - Street 2:BLDG 2, SUITE 120
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-2513
Practice Address - Country:US
Practice Address - Phone:503-684-3988
Practice Address - Fax:503-684-6077
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR8324207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery