Provider Demographics
NPI:1578184321
Name:MIDWEST NEUROLOGY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:MIDWEST NEUROLOGY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-523-6028
Mailing Address - Street 1:5715 N STRECKFUS TRL
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-1769
Mailing Address - Country:US
Mailing Address - Phone:913-523-6028
Mailing Address - Fax:
Practice Address - Street 1:5715 N STRECKFUS TRL
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-1769
Practice Address - Country:US
Practice Address - Phone:913-523-6028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty