Organization Active NPI

Gary W. Neal MD, PLLC

  • Internal Medicine Physician
  • Bristol, TN
National Provider Identifier
1851453922
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GARY W. NEAL MD, PLLC
Practice address
260 Midway Medical Park
Suite 2G
Bristol, TN 37620-1721
Phone
(423) 968-4444
Fax
(423) 844-0359
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Authorized official

Name
Dr. Gary W Neal, M.D.
Title
Owner
Phone
(423) 968-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X TN Primary

Addresses

Primary practice location

260 Midway Medical Park
Suite 2G
Bristol, TN 37620-1721

Mailing address

260 Midway Medical Park
Suite 2G
Bristol, TN 37620-1721
Phone (423) 968-4444

Other identifiers 1

IdentifierTypeStateIssuer
4284719OtherTNBLUE CROSS BLUE SHIELD TN

National Provider Directory

National Provider Directory

Locations

260 Midway Medical Park
Ste 2G
Bristol, TN 37620
Phone (423) 968-4444

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1851453922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MIDWAY MEDICAL PARK",
            "address_2": "SUITE 2G",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201721",
            "telephone_number": "423-968-4444",
            "fax_number": "423-844-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MIDWAY MEDICAL PARK",
            "address_2": "SUITE 2G",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201721",
            "telephone_number": "423-968-4444",
            "fax_number": "423-844-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY W. NEAL MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-968-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4284719",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; 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.