Healthcare Provider Details

I. General information

NPI: 1619387289
Provider Name (Legal Business Name): COMPREHENSIVE NEUROLOGY CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 SEVEN SPRINGS WAY SUITE 201
BRENTWOOD TN
37027
US

IV. Provider business mailing address

2548 RIDEOUT LN
MURFREESBORO TN
37128-7686
US

V. Phone/Fax

Practice location:
  • Phone: 615-410-4990
  • Fax: 615-410-4250
Mailing address:
  • Phone: 615-410-4990
  • Fax: 615-410-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EMILY GREENLEE YOANIDIS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 615-410-4990