Provider Demographics
NPI:1073665568
Name:JOHNNY L. NEIGHBORS, M.D., P.A.
Entity Type:Organization
Organization Name:JOHNNY L. NEIGHBORS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:NEIGHBORS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-487-3334
Mailing Address - Street 1:1506 N LIMESTONE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-4747
Mailing Address - Country:US
Mailing Address - Phone:864-487-3334
Mailing Address - Fax:864-489-4863
Practice Address - Street 1:1506 N LIMESTONE ST
Practice Address - Street 2:SUITE C
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4747
Practice Address - Country:US
Practice Address - Phone:864-487-3334
Practice Address - Fax:864-489-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17618207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1791Medicaid
SCF89200Medicare UPIN