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NPI Code Detail

MEDICARE: INTERVENTIONAL SPINE & NEUROLOGY CENTER PLLC

MEDICARE: INTERVENTIONAL SPINE & NEUROLOGY CENTER PLLC
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 Physician45893TN

General Provider Information

NPI Number : 1154829679
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERVENTIONAL SPINE & NEUROLOGY CENTER PLLC
Provider Business Mailing Address
First Line : 1173 PIN OAK LN
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-8963
Country : US
Telephone Number : 608-217-9776
Fax Number : 615-410-4250
Provider Business Practice Location Address
First Line : 2548 RIDEOUT LN
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-7686
Country : US
Telephone Number : 615-410-4990
Fax Number : 615-410-4250
Authorized Official
Title or Position : PRESIDENT & SOLE OWNER
Name : JOHN SCHNEIDER
Credential : MD
Telephone Number : 615-410-4990
Provider Enumeration Date : 01/30/2018
Last Update Date : 01/30/2018

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Directions to “INTERVENTIONAL SPINE & NEUROLOGY CENTER PLLC ” Practice Location

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