Provider Demographics
NPI:1912565946
Name:VERACITY NEUROSCIENCE LLC
Entity Type:Organization
Organization Name:VERACITY NEUROSCIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LEDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-443-9170
Mailing Address - Street 1:5050 POPLAR AVE STE 511
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38157-0500
Mailing Address - Country:US
Mailing Address - Phone:901-443-9170
Mailing Address - Fax:901-443-0258
Practice Address - Street 1:5050 POPLAR AVE STE 511
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38157-0500
Practice Address - Country:US
Practice Address - Phone:901-443-9170
Practice Address - Fax:901-443-0258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty