Provider Demographics
NPI:1790029486
Name:NEAL, RC JR
Entity Type:Individual
Prefix:
First Name:RC
Middle Name:
Last Name:NEAL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940727 S ROLLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LUTHER
Mailing Address - State:OK
Mailing Address - Zip Code:73054-9670
Mailing Address - Country:US
Mailing Address - Phone:405-650-6548
Mailing Address - Fax:
Practice Address - Street 1:940727 S ROLLINGWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:LUTHER
Practice Address - State:OK
Practice Address - Zip Code:73054
Practice Address - Country:US
Practice Address - Phone:405-589-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management