Individual
MARY C NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
945 W BROADWAY, JACKSON, WY 83001
(307) 734-5999
(307) 734-0345
Mailing address
PO BOX 7369, JACKSON, WY 83002-7369
(307) 734-5999
(307) 734-0345
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
6101A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313180
BLUE CROSS BLUE SHIELD
WY
Enumeration date
12/27/2006
Last updated
09/26/2007
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