Provider Demographics
NPI:1700821824
Name:NEIGHMOND, KEIR (DO)
Entity Type:Individual
Prefix:DR
First Name:KEIR
Middle Name:
Last Name:NEIGHMOND
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 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-8430
Mailing Address - Fax:417-347-8434
Practice Address - Street 1:3202 MCINTOSH CIR
Practice Address - Street 2:STE 301
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3646
Practice Address - Country:US
Practice Address - Phone:417-347-8430
Practice Address - Fax:417-347-8434
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002005852207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209248111Medicaid
MO904933211Medicare PIN
H90727Medicare UPIN