Provider Demographics
NPI:1649778259
Name:IMC-NEUROSURGERY LLC
Entity Type:Organization
Organization Name:IMC-NEUROSURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-1331
Mailing Address - Street 1:3 MOBILE INFIRMARY CIR STE 410
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3512
Mailing Address - Country:US
Mailing Address - Phone:251-435-6850
Mailing Address - Fax:251-435-6859
Practice Address - Street 1:3 MOBILE INFIRMARY CIR STE 410
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3512
Practice Address - Country:US
Practice Address - Phone:251-435-6850
Practice Address - Fax:251-435-6859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty