| Neurology & Neurodiagnostic Clinic Professional Corporation | |
|
606 Wilson Creek Rd Ste. 210 Lawrenceburg IN 47025-1095 | |
| (812) 537-7011 | |
| (812) 537-7021 |
| Full Name | Neurology & Neurodiagnostic Clinic Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 606 Wilson Creek Rd, Lawrenceburg, Indiana |
| Authorized Official Name and Position | Usman A Siddiqui (OWNER) |
| Authorized Official Contact | 8125377011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology & Neurodiagnostic Clinic Professional Corporation Po Box 643046 Cincinnati OH 45264-3046 Ph: (800) 357-5728 | Neurology & Neurodiagnostic Clinic Professional Corporation 606 Wilson Creek Rd Ste. 210 Lawrenceburg IN 47025-1095 Ph: (812) 537-7011 |
| NPI Number | 1740383009 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 09/16/2008 |
| Medicare PECOS PAC ID | 0446269773 |
|---|---|
| Medicare Enrollment ID | O20100211000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740383009 | NPI | - | NPPES |
| 0937400 | Medicaid | OH | |
| 65937062 | Medicaid | KY | |
| 100319400A | Medicaid | IN | |
| 348882200 | Other | US DEPT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Usman A Siddiqui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114927712 PECOS PAC ID: 2264441591 Enrollment ID: I20100211000270 |
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