Provider Demographics
NPI:1942695820
Name:MCNATT, NEILL GAVIN (PHARMD CANDIDATE)
Entity type:Individual
Prefix:
First Name:NEILL
Middle Name:GAVIN
Last Name:MCNATT
Suffix:
Gender:M
Credentials:PHARMD CANDIDATE
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 758
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-0758
Mailing Address - Country:US
Mailing Address - Phone:256-454-6487
Mailing Address - Fax:
Practice Address - Street 1:500 WEBSTER RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-4203
Practice Address - Country:US
Practice Address - Phone:256-454-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10781390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS10781OtherALABAMA BOARD OF PHARMACY