Provider Demographics
NPI:1720193659
Name:NEILL, TERRY A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:A
Last Name:NEILL
Suffix:JR
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-4620
Mailing Address - Fax:850-475-4781
Practice Address - Street 1:5153 N 9TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-416-2554
Practice Address - Fax:850-416-7442
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME965362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology