Individual
JERRY REED MCNEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33173
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044334
BCBS PROVIDER NUMBER
—
01
—
33173
LICENSE
KY
05
—
64331739
—
KY
Enumeration date
09/16/2006
Last updated
12/07/2007
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