Provider Demographics
NPI:1407311764
Name:NEUROSURGICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-524-1869
Mailing Address - Street 1:1932 ALCOA HWY STE 360
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1509
Mailing Address - Country:US
Mailing Address - Phone:865-524-1869
Mailing Address - Fax:865-474-6294
Practice Address - Street 1:9314 PARK WEST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4344
Practice Address - Country:US
Practice Address - Phone:865-524-1869
Practice Address - Fax:865-474-6294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROSURGICAL ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty