Provider Demographics
NPI:1891066874
Name:MCGILL, NEILIA-KAY (MD)
Entity Type:Individual
Prefix:
First Name:NEILIA-KAY
Middle Name:
Last Name:MCGILL
Suffix:
Gender:F
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:PO BOX 732892
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-6339
Mailing Address - Country:US
Mailing Address - Phone:850-437-8640
Mailing Address - Fax:
Practice Address - Street 1:125 BAPTIST WAY STE 4A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2274
Practice Address - Country:US
Practice Address - Phone:448-227-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127893207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017640300Medicaid
FLBIPCCOtherFLORIDA BLUE
FLBIPCCOtherFLORIDA BLUE