Organization
DEKALB PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM F. MCNEILL MD (PRESIDENT)
(404) 501-6700
Entity
Organization
Contact information
Practice address
2701 NORTH DECATUR ROAD, PATHOLOGY DEPT, DECATUR, GA 30033
(404) 501-6700
Mailing address
PO BOX 1457, BLUEFIELD, WV 24701-1457
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300033614A
—
GA
01
—
CN5005
RAILROAD MEDICARE
—
Enumeration date
09/21/2006
Last updated
04/13/2015
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