Provider Demographics
NPI:1710942594
Name:NESBITT, NEAL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:JAMES
Last Name:NESBITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:75 HOSPITAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2857
Practice Address - Country:US
Practice Address - Phone:740-594-6100
Practice Address - Fax:740-594-6903
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064804208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0922863Medicaid
A46132Medicare UPIN
NE0737062Medicare ID - Type Unspecified