Provider Demographics
NPI:1568469914
Name:MCNEELY, RICHARD GREGORY (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GREGORY
Last Name:MCNEELY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 VESTER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-1302
Mailing Address - Country:US
Mailing Address - Phone:937-399-7100
Mailing Address - Fax:937-399-7355
Practice Address - Street 1:1108 VESTER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-1302
Practice Address - Country:US
Practice Address - Phone:937-399-7100
Practice Address - Fax:937-399-7355
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004683207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0782238Medicaid
OHE80165Medicare UPIN
OHMC0665877Medicare ID - Type Unspecified