Provider Demographics
NPI:1750492153
Name:NEYER, THOMAS J (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:NEYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2369 WOODS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-2388
Mailing Address - Country:US
Mailing Address - Phone:812-273-2316
Mailing Address - Fax:
Practice Address - Street 1:1 KINGS DAUGHTERS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3300
Practice Address - Country:US
Practice Address - Phone:812-265-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist