Individual
DR. ROBERT JERRY NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1151 N STATE ST, STE 401, JACKSON, MS 39202
(601) 948-2073
(601) 354-8773
Mailing address
1151 N STATE ST, STE 401, JACKSON, MS 39202
(601) 948-2073
(601) 354-8773
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
228886
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060298
—
MS
Enumeration date
12/14/2006
Last updated
07/08/2007
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