Provider Demographics
NPI:1578176020
Name:NEAVILLE INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:NEAVILLE INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:NEAVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-307-4339
Mailing Address - Street 1:3000 JENNINGS LN STE H
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7255
Mailing Address - Country:US
Mailing Address - Phone:870-307-4339
Mailing Address - Fax:
Practice Address - Street 1:3000 JENNINGS LN STE H
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7255
Practice Address - Country:US
Practice Address - Phone:870-307-4339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty