Provider Demographics
NPI:1730115692
Name:NEELD, JOHN BARTON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BARTON
Last Name:NEELD
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 1:2700 SE STRATUS AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128
Mailing Address - Country:US
Mailing Address - Phone:503-474-1148
Mailing Address - Fax:503-434-6148
Practice Address - Street 1:2700 SE STRATUS AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-474-1148
Practice Address - Fax:503-434-6148
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20393207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150097Medicaid
OR150097Medicaid
ORR142417Medicare PIN