Provider Demographics
NPI:1295741007
Name:NEUROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:NEUROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-782-8949
Mailing Address - Street 1:1301 S CLIFF AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1053
Mailing Address - Country:US
Mailing Address - Phone:605-335-0844
Mailing Address - Fax:605-977-1715
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1023
Practice Address - Country:US
Practice Address - Phone:605-335-0844
Practice Address - Fax:605-977-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND15100Medicaid
IA0000102OtherBCBS - GROUP
ND15050Medicaid
MN90901PAOtherBCBS - GROUP
SD0000102OtherBCBS - GROUP
MN301512200Medicaid
SDCP8237Medicare ID - Type UnspecifiedRAILROAD - GROUP
SDS102Medicare PIN
MN90901PAOtherBCBS - GROUP
ND15050Medicaid
NDN713838Medicare PIN