Provider Demographics
NPI:1689783540
Name:NEAL, FITZHUGH L (MD)
Entity Type:Individual
Prefix:
First Name:FITZHUGH
Middle Name:L
Last Name:NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2587
Mailing Address - Country:US
Mailing Address - Phone:256-383-4473
Mailing Address - Fax:256-381-5232
Practice Address - Street 1:11631 HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:AL
Practice Address - Zip Code:35648-3249
Practice Address - Country:US
Practice Address - Phone:256-229-6262
Practice Address - Fax:256-229-6272
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALMD.17605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115153Medicaid
1326373861OtherSHOALS PRIMARY CARE, LLC GROUP NPI
MS00115153Medicaid
MS080004316Medicare PIN