Individual
MR. BRIAN R NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3050 E RIVER BLUFF BLVD, OZARK, MO 65721-8807
(417) 820-5610
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2003014006
MO
208M00000X
Hospitalist Physician
Primary
2003014006
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992727374
—
MO
01
—
431560263
TRICARE
MO
01
—
P01235237
RR MCR
MO
Enumeration date
07/24/2006
Last updated
12/17/2018
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