Provider Demographics
NPI:1336119239
Name:RINNE, NEAL A (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:A
Last Name:RINNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2611
Mailing Address - Country:US
Mailing Address - Phone:602-258-4951
Mailing Address - Fax:602-254-6840
Practice Address - Street 1:1112 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2611
Practice Address - Country:US
Practice Address - Phone:602-258-4951
Practice Address - Fax:602-254-6840
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18858207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ065757Medicaid
AZE55262Medicare UPIN
AZ065757Medicaid