Organization
COMPETITIVE EDGE SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L NEIGHBORS MD (PRESIDENT)
(618) 526-2603
Entity
Organization
Contact information
Practice address
14160 JAMESTOWN RD, BREESE, IL 62230
(618) 526-2603
(618) 526-1435
Mailing address
9431 HOLY CROSS LN, BREESE, IL 62230-3510
(618) 526-2603
(618) 526-1435
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001400053
BCBS
IL
Enumeration date
12/20/2007
Last updated
12/20/2007
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