Provider Demographics
NPI:1336213628
Name:NEUROLOGIC CONSULTANTS PA
Entity Type:Organization
Organization Name:NEUROLOGIC CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:MCPARTLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-481-8483
Mailing Address - Street 1:PO BOX 270697
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55127-0697
Mailing Address - Country:US
Mailing Address - Phone:651-481-8483
Mailing Address - Fax:
Practice Address - Street 1:12 EAST OAKS ROAD
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55127-2511
Practice Address - Country:US
Practice Address - Phone:651-481-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA95019Medicare UPIN