Provider Demographics
NPI:1851436422
Name:COMPREHENSIVE NEUROLOGICAL SERVICES OF EAST TENNESSEE, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE NEUROLOGICAL SERVICES OF EAST TENNESSEE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAIZ
Authorized Official - Middle Name:E
Authorized Official - Last Name:NIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-478-7687
Mailing Address - Street 1:2810 WESTSIDE DR NW STE H
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3568
Mailing Address - Country:US
Mailing Address - Phone:423-478-7687
Mailing Address - Fax:423-614-8883
Practice Address - Street 1:2810 WESTSIDE DR NW STE H
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3568
Practice Address - Country:US
Practice Address - Phone:423-478-7687
Practice Address - Fax:423-614-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN310322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731622Medicaid
TN3731622Medicaid
TNG70593Medicare UPIN