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General NPI Number Information
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NPI Number | 1740476647
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE NEUROLOGICAL SERVICES
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 131 HOSPITAL DR
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City | SALEM
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State | KY
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Zip | 42078-8043
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Country | US
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Telephone | 270-575-9990
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Fax | 270-575-9950
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Provider Business Mailing Address
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Address Line | 3121 PARISA DR
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City | PADUCAH
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State | KY
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Zip | 42003-4584
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Country | US
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Telephone | 270-575-9990
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Fax | 270-575-9950
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | DR. WILLIAM HOGANCAMP
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Credential | M.D.
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Telephone | 270-575-9990
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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 | 32561
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License Number State | KY
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