Provider Demographics
NPI:1295924785
Name:NEUROLOGY SPECIALISTS INC
Entity type:Organization
Organization Name:NEUROLOGY SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-495-0000
Mailing Address - Street 1:ONE ELIZABETH PLACE
Mailing Address - Street 2:SUITE 210 WEST MEDICAL PLAZA
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45408-1445
Mailing Address - Country:US
Mailing Address - Phone:937-495-0000
Mailing Address - Fax:937-495-0140
Practice Address - Street 1:ONE ELIZABETH PLACE
Practice Address - Street 2:SUITE 210 WEST MEDICAL PLAZA
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45408-1445
Practice Address - Country:US
Practice Address - Phone:937-495-0000
Practice Address - Fax:937-495-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0162818Medicaid
OH9930331Medicare PIN