Provider Demographics
NPI:1336413889
Name:NASHVILLE NEUROLOGICAL CARE CLINIC
Entity Type:Organization
Organization Name:NASHVILLE NEUROLOGICAL CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BATARSEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-678-4171
Mailing Address - Street 1:2200 21ST AVE S
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4942
Mailing Address - Country:US
Mailing Address - Phone:615-678-4171
Mailing Address - Fax:615-678-4172
Practice Address - Street 1:2200 21ST AVE S
Practice Address - Street 2:SUITE 306
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4942
Practice Address - Country:US
Practice Address - Phone:615-678-4171
Practice Address - Fax:615-678-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045976207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I721629Medicare PIN