Provider Demographics
NPI:1265636641
Name:NEUROSURGICAL SOLUTIONS, PA
Entity Type:Organization
Organization Name:NEUROSURGICAL SOLUTIONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-794-0057
Mailing Address - Street 1:145 KIMEL PARK DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6984
Mailing Address - Country:US
Mailing Address - Phone:336-794-0057
Mailing Address - Fax:336-794-0501
Practice Address - Street 1:145 KIMEL PARK DR
Practice Address - Street 2:SUITE 220
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6984
Practice Address - Country:US
Practice Address - Phone:336-794-0057
Practice Address - Fax:336-794-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2339764Medicare ID - Type Unspecified