| Greenville Neurology Center, Llc | |
|
1502 S Colorado St Greenville MS 38703-7219 | |
| (662) 332-9872 | |
| (662) 332-9878 |
| Full Name | Greenville Neurology Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1502 S Colorado St, Greenville, Mississippi |
| Authorized Official Name and Position | Mohammad A Ahmed (OWNER) |
| Authorized Official Contact | 6623329872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenville Neurology Center, Llc 1502 S Colorado St Greenville MS 38703-7219 Ph: (662) 332-9872 | Greenville Neurology Center, Llc 1502 S Colorado St Greenville MS 38703-7219 Ph: (662) 332-9872 |
| NPI Number | 1730446303 |
|---|---|
| Provider Enumeration Date | 04/19/2012 |
| Last Update Date | 04/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730446303 | NPI | - | NPPES |
| 00119831 | Medicaid | MS | |
| 512I130029 | Other | MS | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 16065 (Mississippi) | Primary |
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