Provider Demographics
NPI:1598812455
Name:NEELY, EMILY P (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:NEELY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:D
Other - Last Name:PEOPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-7118
Mailing Address - Country:US
Mailing Address - Phone:615-342-5900
Mailing Address - Fax:615-342-7864
Practice Address - Street 1:330 23RD AVE N STE 500
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:615-342-7864
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47619207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710089Medicaid
3710089Medicare PIN