Healthcare Provider Details

I. General information

NPI: 1003834474
Provider Name (Legal Business Name): NEUROLINKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S UTICA AVE STE 901
TULSA OK
74104-4005
US

IV. Provider business mailing address

1145 S UTICA AVE STE 901
TULSA OK
74104-4005
US

V. Phone/Fax

Practice location:
  • Phone: 918-742-0400
  • Fax: 918-742-0904
Mailing address:
  • Phone: 918-742-0400
  • Fax: 918-742-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. EDWARD BRADLEY VINSON
Title or Position: CEO
Credential: CNIM
Phone: 877-295-2554