Provider Demographics
NPI:1447030291
Name:NEACE, MATTHEW WILLIS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WILLIS
Last Name:NEACE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1602
Mailing Address - Country:US
Mailing Address - Phone:606-218-3576
Mailing Address - Fax:606-218-3961
Practice Address - Street 1:911 BYPASS RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1602
Practice Address - Country:US
Practice Address - Phone:606-218-3576
Practice Address - Fax:606-218-3961
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY023872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist