Provider Demographics
NPI:1235110925
Name:NEUROSURGICAL ASSOCIATES PSC
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-277-6143
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:SUITE B485
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-277-6143
Mailing Address - Fax:859-277-8659
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE B485
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-277-6143
Practice Address - Fax:859-277-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65902900Medicaid
KY65902900Medicaid
KY65902900Medicaid
KY5050Medicare PIN
KY0030500Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
KY5060Medicare PIN