Provider Demographics
NPI:1700986650
Name:SKILLED NEUROLOGY INC
Entity Type:Organization
Organization Name:SKILLED NEUROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LUCY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:205-792-5225
Mailing Address - Street 1:33 RIDGELAND
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1607
Mailing Address - Country:US
Mailing Address - Phone:205-792-5225
Mailing Address - Fax:
Practice Address - Street 1:33 RIDGELAND
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1607
Practice Address - Country:US
Practice Address - Phone:205-792-5225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00010655174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty