Individual
JUSTIN NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4150
Mailing address
1 MEDICAL CENTER DR, MIDDLETOWN, OH 45005-2584
(513) 420-5017
(937) 619-4150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-121363
OH
390200000X
Student in an Organized Health Care Education/Training Program
0116024153
VA
Other
Enumeration date
07/09/2010
Last updated
08/28/2013
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