Provider Demographics
NPI:1073811642
Name:NEUROLOGICAL SURGERY OF AIKEN
Entity Type:Organization
Organization Name:NEUROLOGICAL SURGERY OF AIKEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-226-0130
Mailing Address - Street 1:100 AURORA PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-5318
Mailing Address - Country:US
Mailing Address - Phone:803-226-0130
Mailing Address - Fax:803-226-0156
Practice Address - Street 1:100 AURORA PL
Practice Address - Street 2:SUITE 300
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-5318
Practice Address - Country:US
Practice Address - Phone:803-226-0130
Practice Address - Fax:803-226-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32617174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB09944Medicare UPIN
SC130994Medicare UPIN