| High Country Neurology, Pc | |
|
400 Shadowline Dr Suite 202 Boone NC 28607-5089 | |
| (828) 262-0600 | |
| (828) 262-0807 |
| Full Name | High Country Neurology, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 Shadowline Dr, Boone, North Carolina |
| Authorized Official Name and Position | Laura Miller Crittenden (OFFICE MANAGER) |
| Authorized Official Contact | 8282620600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Country Neurology, Pc 400 Shadowline Dr Suite 202 Boone NC 28607-5089 Ph: (828) 262-0600 | High Country Neurology, Pc 400 Shadowline Dr Suite 202 Boone NC 28607-5089 Ph: (828) 262-0600 |
| NPI Number | 1144300286 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 01/03/2013 |
| Medicare PECOS PAC ID | 1658350962 |
|---|---|
| Medicare Enrollment ID | O20040719001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144300286 | NPI | - | NPPES |
| 791120X | Medicaid | NC | |
| 89015NT | Medicaid | NC | |
| 1073793311 | Other | NPI BURTON LEE KENNEDY | |
| 1740259225 | Other | NC | NPI JEFFREY CRITTENDEN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 9601279 &9401453 (North Carolina) | Primary |
| Provider Name | Jeffrey P Crittenden |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740259225 PECOS PAC ID: 1456330778 Enrollment ID: I20040719001195 |
| Provider Name | Burton Lee Kennedy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073793311 PECOS PAC ID: 3577693787 Enrollment ID: I20100615000604 |
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