Provider Demographics
NPI:1750608592
Name:NEEL, GWENDOLYN (MD)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:
Last Name:NEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5417
Mailing Address - Country:US
Mailing Address - Phone:405-271-9494
Mailing Address - Fax:405-271-3727
Practice Address - Street 1:1501 KINGS HWY
Practice Address - Street 2:DEPARTMENT OF OB/GYN
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-4228
Practice Address - Country:US
Practice Address - Phone:318-675-8295
Practice Address - Fax:318-675-4671
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK31336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology