Provider Demographics
NPI:1851472195
Name:SOKOL, NEAL R (DO)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:R
Last Name:SOKOL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 NW 108TH ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-3729
Mailing Address - Country:US
Mailing Address - Phone:515-334-7524
Mailing Address - Fax:515-334-7528
Practice Address - Street 1:19942 ST. JOSEPH DRIVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-8849
Practice Address - Country:US
Practice Address - Phone:641-774-7730
Practice Address - Fax:515-334-7528
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02942208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2188508Medicaid
IA41239OtherWELLMARK BC/BS
IA1188508Medicaid
IAG11305Medicare UPIN
IAI2007Medicare ID - Type Unspecified