| Advanced Neurology Center | |
|
4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 | |
| (678) 501-5420 | |
| (678) 501-5429 |
| Full Name | Advanced Neurology Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4904 Timber Ridge Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Jeremy Meisel (OWNER) |
| Authorized Official Contact | 6785015420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Neurology Center 1579 Monroe Dr Ne Ste F Suite F602 Atlanta GA 30324-5022 Ph: (678) 501-5420 | Advanced Neurology Center 4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 Ph: (678) 501-5420 |
| NPI Number | 1790118131 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 11/17/2014 |
| Medicare PECOS PAC ID | 1658505276 |
|---|---|
| Medicare Enrollment ID | O20131014000938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790118131 | NPI | - | NPPES |
| 612935883D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 052786 (Georgia) | Primary |
| Provider Name | Jeremy N Meisel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679513865 PECOS PAC ID: 6204890817 Enrollment ID: I20041115000077 |
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