Provider Demographics
NPI:1467086181
Name:NEXT GEN NEURO
Entity Type:Organization
Organization Name:NEXT GEN NEURO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-372-5716
Mailing Address - Street 1:3042 S COUNTY ROAD 475 E
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-8353
Mailing Address - Country:US
Mailing Address - Phone:317-372-5716
Mailing Address - Fax:
Practice Address - Street 1:3042 S COUNTY ROAD 475 E
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-8353
Practice Address - Country:US
Practice Address - Phone:317-372-5716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty