Provider Demographics
NPI:1629148309
Name:NEUROLOGY AND EPILEPSY CLINIC
Entity Type:Organization
Organization Name:NEUROLOGY AND EPILEPSY CLINIC
Other - Org Name:DR NABIL ATALLA MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-685-9830
Mailing Address - Street 1:841 UNION ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2610
Mailing Address - Country:US
Mailing Address - Phone:931-685-9830
Mailing Address - Fax:931-685-9230
Practice Address - Street 1:841 UNION ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2610
Practice Address - Country:US
Practice Address - Phone:931-685-9830
Practice Address - Fax:931-685-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3082220Medicaid
TN3088152OtherBLUE CROSS BLUE SHIELD
TN3082220Medicaid
TN3082220Medicare ID - Type Unspecified
TN3082220Medicaid