Individual
MARIANNE R NEAL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Mailing address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31365
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3130527
BCBS
TN
05
—
3840962
—
TN
01
—
64018062
KENTUCKY MEDICAID
KY
01
—
7222084
VIRGINIA MEDICAID
VA
01
—
89063JK
NORTH CAROLINA MEDICAID
NC
Enumeration date
05/08/2006
Last updated
07/08/2007
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