| Neurology Clinic, Llc | |
|
2400 Hospital Drive Suite 310 Bossier City LA 71111 | |
| (318) 741-2900 | |
| (318) 741-2999 |
| Full Name | Neurology Clinic, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2400 Hospital Drive, Bossier City, Louisiana |
| Authorized Official Name and Position | Sanjeevi C. Tivakaran (CEO) |
| Authorized Official Contact | 3187412900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Clinic, Llc 2400 Hospital Drive Suite 310 Bossier City LA 71111 Ph: (318) 741-2900 | Neurology Clinic, Llc 2400 Hospital Drive Suite 310 Bossier City LA 71111 Ph: (318) 741-2900 |
| NPI Number | 1205928819 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 09/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205928819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 11838R (Louisiana) | Primary |
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