Provider Demographics
NPI:1609042670
Name:NEILL, WILLIAM T
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:T
Last Name:NEILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 MEMORIAL PKWY SW STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5394
Mailing Address - Country:US
Mailing Address - Phone:256-881-2007
Mailing Address - Fax:256-883-3008
Practice Address - Street 1:3007 MEMORIAL PKWY SW STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5394
Practice Address - Country:US
Practice Address - Phone:256-881-2007
Practice Address - Fax:256-883-3008
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1723156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician