Provider Demographics
NPI:1225217664
Name:NEUROLOGICAL SURGERY OF COVINGTON PLLC
Entity Type:Organization
Organization Name:NEUROLOGICAL SURGERY OF COVINGTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEEMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-892-9233
Mailing Address - Street 1:64040 HWY 434
Mailing Address - Street 2:STE 200
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445
Mailing Address - Country:US
Mailing Address - Phone:985-892-9233
Mailing Address - Fax:985-892-8916
Practice Address - Street 1:64040 HWY 434
Practice Address - Street 2:STE 200
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445
Practice Address - Country:US
Practice Address - Phone:985-892-9233
Practice Address - Fax:985-892-8916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0531R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1465062Medicaid
LA5CR74Medicare PIN