Provider Demographics
NPI:1215150560
Name:NEAL J. NESBITT, M.D., INC.
Entity type:Organization
Organization Name:NEAL J. NESBITT, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-594-6100
Mailing Address - Street 1:75 HOSPITAL DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2857
Mailing Address - Country:US
Mailing Address - Phone:740-594-6100
Mailing Address - Fax:740-594-6903
Practice Address - Street 1:75 HOSPITAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2857
Practice Address - Country:US
Practice Address - Phone:740-594-6100
Practice Address - Fax:740-594-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064804208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2550378Medicaid
A46132Medicare UPIN
OH2550378Medicaid