Provider Demographics
NPI:1083752513
Name:CONNELL, NEVILLE KENNETH (MD MPH)
Entity Type:Individual
Prefix:
First Name:NEVILLE
Middle Name:KENNETH
Last Name:CONNELL
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 RICHMOND
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED ST CROIX
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4370
Mailing Address - Country:US
Mailing Address - Phone:340-773-1311
Mailing Address - Fax:340-778-1438
Practice Address - Street 1:3500 RICHMOND
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4370
Practice Address - Country:US
Practice Address - Phone:340-773-1311
Practice Address - Fax:340-778-1438
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine