Provider Demographics
NPI:1578920625
Name:GREYSTONE NEUROLOGY AND PAIN CENTERS, INC
Entity Type:Organization
Organization Name:GREYSTONE NEUROLOGY AND PAIN CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-991-3300
Mailing Address - Street 1:7500 HUGH DANIEL DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7148
Mailing Address - Country:US
Mailing Address - Phone:205-991-3300
Mailing Address - Fax:205-991-3327
Practice Address - Street 1:7500 HUGH DANIEL DR
Practice Address - Street 2:SUITE 250
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7148
Practice Address - Country:US
Practice Address - Phone:205-991-3300
Practice Address - Fax:205-991-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL183897Medicaid