Individual
NEAL J PRENDERGAST JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01069486A
IN
208800000X
Urology Physician
Primary
32911
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10805597
CAQH PROVIDER ID
—
05
—
201028550
—
IN
05
—
64329113
—
KY
01
—
P00314098
RAILROAD MEDICARE
KY
01
—
P00895260
RAILROAD MEDICARE
KY
Enumeration date
09/29/2005
Last updated
08/24/2016
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