Provider Demographics
NPI:1164757761
Name:MCNEIL, JASON MICHAEL (NMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16655 N 90TH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2788
Mailing Address - Country:US
Mailing Address - Phone:602-465-8493
Mailing Address - Fax:602-465-8493
Practice Address - Street 1:16655 N 90TH ST
Practice Address - Street 2:STE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2788
Practice Address - Country:US
Practice Address - Phone:602-465-8493
Practice Address - Fax:602-465-8493
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1145175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath