Provider Demographics
NPI:1851329387
Name:NEUROLOGY AND SLEEP SCIENCES, P.C.
Entity Type:Organization
Organization Name:NEUROLOGY AND SLEEP SCIENCES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAGEDORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-376-3100
Mailing Address - Street 1:PO BOX 2547
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47202-2547
Mailing Address - Country:US
Mailing Address - Phone:812-376-3100
Mailing Address - Fax:812-378-6191
Practice Address - Street 1:1655 N GLADSTONE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5380
Practice Address - Country:US
Practice Address - Phone:812-376-3100
Practice Address - Fax:812-378-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200330450Medicaid
IN182050Medicare PIN