Provider Demographics
NPI:1073848636
Name:GALEN, NEAL (DO)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:
Last Name:GALEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1728 WEST GLENDALE AVENUE
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-8862
Mailing Address - Country:US
Mailing Address - Phone:602-246-4917
Mailing Address - Fax:602-246-1432
Practice Address - Street 1:1820 W MARYLAND AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1740
Practice Address - Country:US
Practice Address - Phone:602-246-4917
Practice Address - Fax:602-246-1432
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2016-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1760208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ204131OtherAHCCCS
AZ204131Medicaid
AZE44489Medicare UPIN
AZ204131Medicaid