Individual
JAMES J.L. NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1930 N BUSINESS ROUTE 5, UNIT 1A, CAMDENTON, MO 65020-2659
(573) 346-5624
(573) 346-1957
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007028775
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013181601
—
MO
01
—
135570004
MEDICARE PTAN
MO
01
—
P00631928
RAILROAD MEDICARE
MO
Enumeration date
04/15/2008
Last updated
07/13/2009
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