Provider Demographics
NPI:1437255064
Name:NEYHART, GENE M (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:M
Last Name:NEYHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3700 E MISHAWAKA RD
Mailing Address - Street 2:2
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-3550
Mailing Address - Country:US
Mailing Address - Phone:574-875-0100
Mailing Address - Fax:574-875-0114
Practice Address - Street 1:3700 E MISHAWAKA RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-3550
Practice Address - Country:US
Practice Address - Phone:574-875-0100
Practice Address - Fax:574-875-0114
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN08001259A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU17016Medicare UPIN
IN327110Medicare ID - Type Unspecified