Healthcare Provider Details

I. General information

NPI: 1891035606
Provider Name (Legal Business Name): NEUROLOGY CONSULTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STONECREST BLVD SUITE 260
SMYRNA TN
37167-5688
US

IV. Provider business mailing address

300 STONECREST BLVD SUITE 260
SMYRNA TN
37167-5688
US

V. Phone/Fax

Practice location:
  • Phone: 615-223-5564
  • Fax: 615-223-5860
Mailing address:
  • Phone: 615-223-5564
  • Fax: 615-223-5860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number38196
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number38196
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number38196
License Number StateTN

VIII. Authorized Official

Name: MR. PAWEL ZYGLEWSKI
Title or Position: SECRETARY
Credential:
Phone: 615-223-5564