Provider Demographics
NPI:1477684918
Name:NORMAN C. NEEB, DO, INC
Entity Type:Organization
Organization Name:NORMAN C. NEEB, DO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:NEEB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:314-984-0033
Mailing Address - Street 1:12166 OLD BIG BEND RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6844
Mailing Address - Country:US
Mailing Address - Phone:314-984-0033
Mailing Address - Fax:314-984-0020
Practice Address - Street 1:12166 OLD BIG BEND RD
Practice Address - Street 2:SUITE 108
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6844
Practice Address - Country:US
Practice Address - Phone:314-984-0033
Practice Address - Fax:314-984-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1J92204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO180821OtherBLUE CROSS BLUE SHIELD
MO2300025OtherUNITED HEALTH CARE
MO4585451OtherAETNA
MO133154OtherHEALTHLINK
MO180821OtherBLUE CROSS BLUE SHIELD
MOE69192Medicare UPIN