Provider Demographics
NPI:1366821407
Name:KIINGS NEUROLOGICAL CARE
Entity Type:Organization
Organization Name:KIINGS NEUROLOGICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUKAYODE
Authorized Official - Middle Name:OLUSEUN
Authorized Official - Last Name:ONASANYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-365-1001
Mailing Address - Street 1:445 DOLLEY MADISON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5169
Mailing Address - Country:US
Mailing Address - Phone:336-365-1001
Mailing Address - Fax:336-897-1533
Practice Address - Street 1:445 DOLLEY MADISON RD STE 210
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5169
Practice Address - Country:US
Practice Address - Phone:336-365-1001
Practice Address - Fax:336-897-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00255261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty