Provider Demographics
NPI:1235717562
Name:MEADOWLARK NEUROMONITORING LLC
Entity Type:Organization
Organization Name:MEADOWLARK NEUROMONITORING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-374-6628
Mailing Address - Street 1:7131 W 135TH ST # 1006
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1238
Mailing Address - Country:US
Mailing Address - Phone:866-374-6628
Mailing Address - Fax:866-951-1120
Practice Address - Street 1:7131 W 135TH ST # 1006
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1238
Practice Address - Country:US
Practice Address - Phone:866-374-6628
Practice Address - Fax:866-951-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty