Provider Demographics
NPI:1861461436
Name:NEUROLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-383-2667
Mailing Address - Street 1:4700 E 56TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2903
Mailing Address - Country:US
Mailing Address - Phone:563-383-2667
Mailing Address - Fax:563-383-2672
Practice Address - Street 1:4700 E 56TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2903
Practice Address - Country:US
Practice Address - Phone:563-383-2667
Practice Address - Fax:563-383-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0219014Medicaid
21901OtherWELLMARK BCBS
CP8140OtherRAILROAD MEDICARE
IA21901Medicare ID - Type Unspecified
21901OtherWELLMARK BCBS
IA21901Medicare ID - Type Unspecified
IA0219014Medicaid