Provider Demographics
NPI:1457457806
Name:TENNESSEE VALLEY NEUROLOGY, PC
Entity Type:Organization
Organization Name:TENNESSEE VALLEY NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JANNUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-718-5900
Mailing Address - Street 1:PO BOX 10000
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2000
Mailing Address - Country:US
Mailing Address - Phone:256-718-5900
Mailing Address - Fax:256-718-5918
Practice Address - Street 1:2407 HELTON DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1067
Practice Address - Country:US
Practice Address - Phone:256-718-5900
Practice Address - Fax:256-718-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty