Provider Demographics
NPI:1386665198
Name:NEAL, JANICE W (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:W
Last Name:NEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 14TH AVE SE
Mailing Address - Street 2:SUITE G400
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 14TH AVE SE
Practice Address - Street 2:SUITE G400
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3309
Practice Address - Country:US
Practice Address - Phone:256-309-5622
Practice Address - Fax:256-309-5696
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00019301207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51529947OtherBCBS
ALG56840Medicare UPIN