Provider Demographics
NPI:1043482664
Name:JEFFERY C. MCNEELY, D.P.M., P.A.
Entity Type:Organization
Organization Name:JEFFERY C. MCNEELY, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODITARIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:MCNEELY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:806-744-1168
Mailing Address - Street 1:2126 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-2619
Mailing Address - Country:US
Mailing Address - Phone:806-744-1168
Mailing Address - Fax:806-744-2368
Practice Address - Street 1:2126 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2619
Practice Address - Country:US
Practice Address - Phone:806-744-1168
Practice Address - Fax:806-744-2368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1130850001Medicare NSC