Provider Demographics
NPI:1851728430
Name:KCA NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:KCA NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:615-550-1800
Mailing Address - Street 1:4323 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 609
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5914
Mailing Address - Country:US
Mailing Address - Phone:615-550-1800
Mailing Address - Fax:615-550-1801
Practice Address - Street 1:311 LANDRUM PL
Practice Address - Street 2:SUITE B400
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6319
Practice Address - Country:US
Practice Address - Phone:615-550-1800
Practice Address - Fax:615-550-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty