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General NPI Number Information
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NPI Number | 1740383009
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Entity Type | Organization
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Legal Business Name | NEUROLOGY & NEURODIAGNOSTIC CLINIC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 606 WILSON CREEK RD STE. 210
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-1095
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Country | US
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Telephone | 812-537-7011
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Fax | 812-537-7021
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Provider Business Mailing Address
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Address Line | PO BOX 643046
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City | CINCINNATI
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State | OH
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Zip | 45264-3046
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Country | US
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Telephone | 800-357-5728
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Fax | 937-291-2962
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Authorized Official
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Title or Position | OWNER
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Name | USMAN A SIDDIQUI
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Credential | MD
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Telephone | 812-537-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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