Provider Demographics
NPI:1578569091
Name:NEIL, MATTHEW L (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:NEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-1113
Mailing Address - Country:US
Mailing Address - Phone:563-421-9880
Mailing Address - Fax:563-421-9919
Practice Address - Street 1:301 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1113
Practice Address - Country:US
Practice Address - Phone:563-285-7232
Practice Address - Fax:563-285-6742
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1214015Medicaid
IA01J6OtherJOHN DEERE HEALTH PLAN
34843OtherWELLMARK BC/BS
208141OtherIOWA HEALTH SOLUTIONS
085492OtherHEALTH ALLIANCE
4796890010OtherDMERC
208141OtherIOWA HEALTH SOLUTIONS
085492OtherHEALTH ALLIANCE
4796890010OtherDMERC