Individual
JENNIFER JEANNE MCNEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 N CALIFORNIA ST, STOCKTON, CA 95204-6005
(209) 946-6800
(209) 946-6805
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, 2ND FL, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
22673
OK
208C00000X
Colon & Rectal Surgery Physician
Primary
G127680
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210840A
—
OK
Enumeration date
07/25/2006
Last updated
10/29/2014
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