Provider Demographics
NPI:1225329667
Name:ALCOVY NEUROLOGY
Entity Type:Organization
Organization Name:ALCOVY NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:LACAYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-905-9625
Mailing Address - Street 1:3535 HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-4336
Mailing Address - Country:US
Mailing Address - Phone:678-905-9625
Mailing Address - Fax:770-674-5880
Practice Address - Street 1:3535 HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4336
Practice Address - Country:US
Practice Address - Phone:678-905-9625
Practice Address - Fax:770-674-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty