Provider Demographics
NPI:1801007448
Name:OCALA NEURODIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:OCALA NEURODIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-598-4330
Mailing Address - Street 1:PO BOX 6480
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-6480
Mailing Address - Country:US
Mailing Address - Phone:352-598-4330
Mailing Address - Fax:352-694-6848
Practice Address - Street 1:1901 SE 18TH AVE
Practice Address - Street 2:BLDG 400
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8215
Practice Address - Country:US
Practice Address - Phone:352-598-4330
Practice Address - Fax:352-694-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty