Provider Demographics
NPI:1033540927
Name:JAMES P. NEALON, MD, PC
Entity Type:Organization
Organization Name:JAMES P. NEALON, MD, PC
Other - Org Name:JAMES P. NEALON, MD, FACS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:NEALON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-874-0574
Mailing Address - Street 1:450 WELCH ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1934
Mailing Address - Country:US
Mailing Address - Phone:503-874-0574
Mailing Address - Fax:503-874-0575
Practice Address - Street 1:450 WELCH ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1934
Practice Address - Country:US
Practice Address - Phone:503-874-0574
Practice Address - Fax:503-874-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23140208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty