Provider Demographics
NPI:1689820243
Name:NEUROPATHY CLINICS OF TENNESSEE, PLLC
Entity Type:Organization
Organization Name:NEUROPATHY CLINICS OF TENNESSEE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-664-0899
Mailing Address - Street 1:3035 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3411
Mailing Address - Country:US
Mailing Address - Phone:731-664-0899
Mailing Address - Fax:731-664-0946
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE 290
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:731-664-0899
Practice Address - Fax:731-664-0946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN 019569174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty