Jerry Reed McNeal, MD
Individual provider Active NPI Pediatrics Physician · Madisonville, KY
NPI 1154427870 · NPPES record last updated Dec 7, 2007
Key facts
- NPI
- 1154427870
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 33173 (KY)
- Practice address
- 200 Clinic Dr
Madisonville, KY 42431-1661 - Phone
- (270) 825-7200
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 33173 | KY | Yes |
Addresses
Primary practice location
200 Clinic Dr
Madisonville, KY 42431-1661
Mailing address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 825-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64331739 | Medicaid | KY | |
| 000000044334 | Other | BCBS PROVIDER NUMBER | |
| 33173 | Other | KY | LICENSE |
Other providers in Madisonville, KY
- Melanie McGlothlin
- Stacey Leigh McGregor
- Rian McGuyer
- Tanya Dean McKinsey
- Rihana Paige McKnight
- James Diamond McNevin
- Medical Center Ambulance Service Inc
- Tina Meece-Terpening
- Christinia Nicole Melton
- Crystal C. Menser
All providers in Madisonville, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.