Provider Demographics
NPI:1740947225
Name:NEUROPATHY CLINIC PLLC
Entity type:Organization
Organization Name:NEUROPATHY CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HALSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-607-6125
Mailing Address - Street 1:3117 S ROCKFORD DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2128
Mailing Address - Country:US
Mailing Address - Phone:918-607-6125
Mailing Address - Fax:
Practice Address - Street 1:5995 SOUTH POINT BLVD STE 109
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3273
Practice Address - Country:US
Practice Address - Phone:239-362-2545
Practice Address - Fax:239-362-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty