Healthcare Provider Details

I. General information

NPI: 1689614406
Provider Name (Legal Business Name): CENTER FOR NEUROLOGICAL TREATMENT & RESEARCH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 QUECREEK CIR
SMYRNA TN
37167-6834
US

IV. Provider business mailing address

301 QUECREEK CIR
SMYRNA TN
37167-6834
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberDO1145
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD19415
License Number StateTN

VIII. Authorized Official

Name: DR. RICHARD RUBINOWICZ
Title or Position: CHIEF MANAGER
Credential: M.D.
Phone: 615-355-5510