Provider Demographics
NPI:1972707982
Name:CENTER FOR NEUROLOGICAL TREATMENT & RESEARCH, PLLC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGICAL TREATMENT & RESEARCH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF 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:615-333-5510
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 1:331 LANDRUM PL
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6329
Practice Address - Country:US
Practice Address - Phone:615-355-5510
Practice Address - Fax:615-355-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3717551Medicaid
TNCG4522OtherRAILROAD MEDICARE
TN3717551Medicaid
TNCG4522OtherRAILROAD MEDICARE