| Northwest Neurology, P.c. | |
|
4460 Austell Rd Austell GA 30106-1844 | |
| (770) 941-4716 | |
| (770) 941-3047 |
| Full Name | Northwest Neurology, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4460 Austell Rd, Austell, Georgia |
| Authorized Official Name and Position | Gary Jay Kaplan (FINANCIAL OFFICER) |
| Authorized Official Contact | 7708191717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Neurology, P.c. 3875 Austell Rd Suite 204 Austell GA 30106-1103 Ph: (770) 819-1717 | Northwest Neurology, P.c. 4460 Austell Rd Austell GA 30106-1844 Ph: (770) 941-4716 |
| NPI Number | 1942360912 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 12/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942360912 | NPI | - | NPPES |
| CB2386 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 012499 (Georgia) | Primary |
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