Healthcare Provider Details

I. General information

NPI: 1215169131
Provider Name (Legal Business Name): THE NEUROLOGY CENTER OF GADSDEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S 4TH ST
GADSDEN AL
35901-5217
US

IV. Provider business mailing address

502 S 4TH ST
GADSDEN AL
35901-5217
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-8988
  • Fax: 256-547-8986
Mailing address:
  • Phone: 256-547-8988
  • Fax: 256-547-8986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number19952
License Number StateAL

VIII. Authorized Official

Name: DR. JOHN A JUST
Title or Position: OWNER
Credential: M.D.
Phone: 256-547-8988