Provider Demographics
NPI:1609810563
Name:NEELEY, KAREN F (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:F
Last Name:NEELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1340
Mailing Address - Country:US
Mailing Address - Phone:812-885-0520
Mailing Address - Fax:812-885-0517
Practice Address - Street 1:406 N 1ST ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1340
Practice Address - Country:US
Practice Address - Phone:812-885-0520
Practice Address - Fax:812-885-0517
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040382A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200003320Medicaid
IN000000516781OtherANTHEM BCBS #
IN000000516781OtherANTHEM BCBS #
IN200003320Medicaid
IN258190048Medicare PIN