Individual
JERRID NEELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7547 MEDICAL DR STE 1200, GLOUCESTER, VA 23061-4351
(804) 693-2670
(804) 693-3704
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0102206146
VA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/11/2017
Last updated
09/03/2020
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