Newnan Neurology Pc | |
60 Oak Hill Blvd Suite 103 Newnan GA 30265-2314 | |
(770) 683-8637 | |
(770) 683-8633 |
Full Name | Newnan Neurology Pc |
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Speciality | Psychiatry & Neurology |
Location | 60 Oak Hill Blvd, Newnan, Georgia |
Authorized Official Name and Position | Qing Ni (OWNER) |
Authorized Official Contact | 7706838637 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Newnan Neurology Pc 60 Oak Hill Blvd Suite 103 Newnan GA 30265-2314 Ph: (770) 683-8637 | Newnan Neurology Pc 60 Oak Hill Blvd Suite 103 Newnan GA 30265-2314 Ph: (770) 683-8637 |
NPI Number | 1104231240 |
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Provider Enumeration Date | 06/27/2014 |
Last Update Date | 07/01/2014 |
Medicare PECOS PAC ID | 9830316223 |
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Medicare Enrollment ID | O20140807002283 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104231240 | NPI | - | NPPES |
639314016 | Medicaid | GA | |
646750194A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 57404 (Georgia) | Primary |
Provider Name | Xiaoyan Guo |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1548290661 PECOS PAC ID: 9436162492 Enrollment ID: I20060718000018 |
Provider Name | Qing Ni |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1295765311 PECOS PAC ID: 7517970577 Enrollment ID: I20060718000023 |
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