Provider Demographics
NPI:1649292418
Name:MCNEIL, BENJAMIN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SEVERN AVE
Mailing Address - Street 2:STE 8
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3451
Mailing Address - Country:US
Mailing Address - Phone:504-835-0565
Mailing Address - Fax:504-835-0985
Practice Address - Street 1:3501 SEVERN AVE
Practice Address - Street 2:STE 8
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3451
Practice Address - Country:US
Practice Address - Phone:504-835-0565
Practice Address - Fax:504-835-0985
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H773DU06Medicare UPIN