Healthcare Provider Details

I. General information

NPI: 1972700417
Provider Name (Legal Business Name): CENTER FOR NEUROLOGICAL TREATMENT AND RESEARCH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 REN MAR DR SUITE 200
PLEASANT VIEW TN
37146-3722
US

IV. Provider business mailing address

515 STONECREST PKWY SUITE 200
SMYRNA TN
37167-6826
US

V. Phone/Fax

Practice location:
  • Phone: 615-746-4533
  • Fax: 615-746-4636
Mailing address:
  • Phone: 615-355-5510
  • Fax: 615-355-8699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberDO1145
License Number StateTN

VIII. Authorized Official

Name: RICHARD RUBINOWICZ
Title or Position: CHIEF MANAGER
Credential: MD
Phone: 615-355-5510