Provider Demographics
NPI:1629239603
Name:PONDER, NEIL MEREDITH (DO)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:MEREDITH
Last Name:PONDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-0925
Mailing Address - Country:US
Mailing Address - Phone:509-946-7900
Mailing Address - Fax:509-946-7944
Practice Address - Street 1:4309 W 27TH PL STE 300
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2909
Practice Address - Country:US
Practice Address - Phone:509-491-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-22
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255855207V00000X
WAOP60262172207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology