Provider Demographics
NPI:1730349614
Name:NEIL, RYAN FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:FREDERICK
Last Name:NEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TACON ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3123
Mailing Address - Country:US
Mailing Address - Phone:251-341-2879
Mailing Address - Fax:
Practice Address - Street 1:51 TACON ST
Practice Address - Street 2:SUITE D
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3123
Practice Address - Country:US
Practice Address - Phone:251-341-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31397207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine