| Medgen Neuro | |
|
824 N Creek Dr Conway AR 72032-4711 | |
| (999) 999-9999 | |
| Not Available |
| Full Name | Medgen Neuro |
|---|---|
| Speciality | Physiological Laboratory |
| Location | 824 N Creek Dr, Conway, Arkansas |
| Authorized Official Name and Position | Deanne Goss (MANAGING MEMBER) |
| Authorized Official Contact | 9999999999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medgen Neuro 824 N Creek Dr Conway AR 72032-4711 Ph: (999) 999-9999 | Medgen Neuro 824 N Creek Dr Conway AR 72032-4711 Ph: (999) 999-9999 |
| NPI Number | 1487313557 |
|---|---|
| Provider Enumeration Date | 12/15/2021 |
| Last Update Date | 01/17/2022 |
| Certification Date | 01/17/2022 |
| Medicare PECOS PAC ID | 5991183832 |
|---|---|
| Medicare Enrollment ID | O20220603002161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487313557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 293D00000X | Physiological Laboratory | (* (Not Available)) | Primary |
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