Provider Demographics
NPI:1750577706
Name:NEUROLOGY AND NEURODIAGNOSTICS OF ALABAMA, LLC
Entity type:Organization
Organization Name:NEUROLOGY AND NEURODIAGNOSTICS OF ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-699-1632
Mailing Address - Street 1:1000 SOUTHLAKE PARK
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5700
Mailing Address - Country:US
Mailing Address - Phone:205-621-4799
Mailing Address - Fax:866-546-2124
Practice Address - Street 1:1000 SOUTHLAKE PARK
Practice Address - Street 2:STE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-5700
Practice Address - Country:US
Practice Address - Phone:205-699-1632
Practice Address - Fax:866-546-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-22
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty