Provider Demographics
NPI:1235336975
Name:MID TENNESSEE NEUROLOGY ASSOCIATES,PLC
Entity Type:Organization
Organization Name:MID TENNESSEE NEUROLOGY ASSOCIATES,PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAN-REN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-391-8160
Mailing Address - Street 1:5651 FRIST BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2054
Mailing Address - Country:US
Mailing Address - Phone:615-391-8160
Mailing Address - Fax:615-391-9086
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2054
Practice Address - Country:US
Practice Address - Phone:615-391-8160
Practice Address - Fax:615-391-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3377596Medicare ID - Type UnspecifiedMEDICARE