Provider Demographics
NPI:1952625188
Name:JEFFERSON NEUROLOGY, LLC
Entity Type:Organization
Organization Name:JEFFERSON NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-482-5515
Mailing Address - Street 1:1801 HIGHWAY 99 N
Mailing Address - Street 2:STE 2
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9152
Mailing Address - Country:US
Mailing Address - Phone:541-482-5515
Mailing Address - Fax:541-482-2433
Practice Address - Street 1:1801 HIGHWAY 99 N
Practice Address - Street 2:STE 2
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9152
Practice Address - Country:US
Practice Address - Phone:541-482-5515
Practice Address - Fax:541-482-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25117204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty