Charles A Neal IV, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

1701 Hardee Ave SW
Fort McPherson, GA 30330-1062

Phone

(404) 464-0414

Fax

(404) 464-0410

NPI assigned

Sep 11, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1073708293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 HARDEE AVE SW",
            "city": "FORT MCPHERSON",
            "state": "GA",
            "postal_code": "303301062",
            "telephone_number": "404-464-0414",
            "fax_number": "404-464-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 HARDEE AVE SW",
            "city": "FORT MCPHERSON",
            "state": "GA",
            "postal_code": "303301062",
            "telephone_number": "404-464-0414",
            "fax_number": "404-464-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Joel Army Health Clinic
• Juanita McKinnon Little, LPN
• Dennis Chaves Loura, NP-C
• Sharon Yvonne McCreary
• Martha Stewart McNair, LPN
• Sheila Corteiz Norris, PHARM. D
• Ileana Rogers
• Merri Barton Slick, LCSW
• Dianne Terrell Smith I, RN
• Corrinne Anne Thames, LPN

• All providers in Fort McPherson, GA
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.