Individual
MICHELE L NEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9001 S 101ST EAST AVE, STE 200, TULSA, OK 74133-5708
(918) 392-5600
(918) 392-5611
Mailing address
7912 E 31ST CT, STE 210, TULSA, OK 74145-1315
(918) 392-4477
(918) 392-4465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4105
OK
207RS0010X
Sports Medicine (Internal Medicine) Physician
4105
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200064880B
—
OK
01
—
800522535
MEDICARE GROUP PIN
OK
Enumeration date
11/01/2006
Last updated
05/16/2008
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