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NPI Code Detail

MEDICARE: NEURO RESOURCE PC

MEDICARE: NEURO RESOURCE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician012943TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12000950OTHERTNBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114041548
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEURO RESOURCE PC
Provider Business Mailing Address
First Line : 3443 DICKERSON PIKE STE 300
Second Line :
City : NASHVILLE
State : TN
Zip : 37207-2523
Country : US
Telephone Number : 615-868-0200
Fax Number : 615-865-5999
Provider Business Practice Location Address
First Line : 3443 DICKERSON PIKE STE 300
Second Line :
City : NASHVILLE
State : TN
Zip : 37207-2523
Country : US
Telephone Number : 615-868-0200
Fax Number : 615-865-5999
Authorized Official
Title or Position : OWNER
Name : PAULO ACOSTA
Credential : MD
Telephone Number : 615-868-0200
Provider Enumeration Date : 03/19/2007
Last Update Date : 09/15/2011

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Directions to “NEURO RESOURCE PC ” Practice Location

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