Provider Demographics
NPI:1184706111
Name:NEEL, JERRY D JR (OD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:D
Last Name:NEEL
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 CALLE ROSALES
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2832
Mailing Address - Country:US
Mailing Address - Phone:805-886-6052
Mailing Address - Fax:
Practice Address - Street 1:7095 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-5905
Practice Address - Country:US
Practice Address - Phone:805-562-1300
Practice Address - Fax:805-966-5840
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10213T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist