Individual
JOHN NEEL RANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4222 FAIRBANKS DR, OAKWOOD, GA 30566-2811
(770) 534-6053
(770) 534-6695
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
021274
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000252755C
—
GA
01
—
0100290
UNITED HEALTHCARE
GA
01
—
10045373
AMERIGROUP
GA
01
—
341308
WELLCARE
GA
01
—
4105859
AETNA PPO
GA
01
—
52046825
BCBS
GA
01
—
6679698
CIGNA
GA
01
—
80075271
RR MEDICARE-GRP # CC4177
GA
Enumeration date
01/23/2006
Last updated
10/26/2018
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