Organization Name: | P MARK NEAL MD LLC |
NPI Number: | 1104180728 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | P MARK NEAL (SOLE PROPRIETOR) |
Mailing Address: | 12 Professional Dr Houma |
State: | LA US |
Postal Code: | 703604046 |
Phone Number: | 9858681810 |
Fax Number: | 9858763670 |
NPI Enumeration Date: | 06/28/2012 |
NPI Last Update Date: | 06/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 202640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |