Greenwood Neurology Clinic | |
1317 River Rd Greenwood MS 38930 | |
(662) 459-2520 | |
Not Available |
Full Name | Greenwood Neurology Clinic |
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Speciality | Psychiatry & Neurology |
Location | 1317 River Rd, Greenwood, Mississippi |
Authorized Official Name and Position | Dawne Holmes (CFO) |
Authorized Official Contact | 6624597119 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Greenwood Neurology Clinic Po Box 1410 Greenwood MS 38935-1410 Ph: (662) 459-2520 | Greenwood Neurology Clinic 1317 River Rd Greenwood MS 38930 Ph: (662) 459-2520 |
NPI Number | 1083674204 |
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Provider Enumeration Date | 03/23/2006 |
Last Update Date | 07/02/2018 |
Medicare PECOS PAC ID | 7517031313 |
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Medicare Enrollment ID | O20080728000452 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083674204 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Ravi Pande |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1326008913 PECOS PAC ID: 1850417783 Enrollment ID: I20100928000922 |
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