Provider Demographics
NPI:1801006390
Name:MCNEIL, LARRY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:WAYNE
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:105 PAXTON CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4751
Mailing Address - Country:US
Mailing Address - Phone:615-661-5908
Mailing Address - Fax:615-350-2813
Practice Address - Street 1:7575 COCKRILL BEND BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1056
Practice Address - Country:US
Practice Address - Phone:615-350-2700
Practice Address - Fax:615-350-2813
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD010669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB03279Medicare UPIN