Provider Demographics
NPI:1972700417
Name:CENTER FOR NEUROLOGICAL TREATMENT AND RESEARCH PLLC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGICAL TREATMENT AND RESEARCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBINOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-355-5510
Mailing Address - Street 1:515 STONECREST PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6826
Mailing Address - Country:US
Mailing Address - Phone:615-355-5510
Mailing Address - Fax:615-355-8699
Practice Address - Street 1:254 REN MAR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-3722
Practice Address - Country:US
Practice Address - Phone:615-746-4533
Practice Address - Fax:615-746-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO11452084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3039399OtherBCBS
TN3802609Medicaid
TNTN0101Medicaid
TNCG4522OtherMEDICARE RR
TN3802608Medicare PIN
TN3717552Medicare ID - Type Unspecified