Provider Demographics
NPI:1942499140
Name:ARTHUR P. DICK NEUROLOGY, INC.
Entity Type:Organization
Organization Name:ARTHUR P. DICK NEUROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:P
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-529-7090
Mailing Address - Street 1:14601 DETROIT AVE
Mailing Address - Street 2:SUITE 480
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4214
Mailing Address - Country:US
Mailing Address - Phone:216-529-7090
Mailing Address - Fax:
Practice Address - Street 1:14601 DETROIT AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4214
Practice Address - Country:US
Practice Address - Phone:216-529-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350512172084N0400X
OH161189363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0699749Medicaid
OH9314751Medicare PIN