Recon Neurology & Psychiatry | |
1340 Walter Reed Rd Ste 202 Fayetteville NC 28304-4451 | |
(910) 504-3506 | |
(910) 504-3507 |
Full Name | Recon Neurology & Psychiatry |
---|---|
Speciality | Psychiatry & Neurology |
Location | 1340 Walter Reed Rd Ste 202, Fayetteville, North Carolina |
Authorized Official Name and Position | Matthew Kyle Banks (OWNER/DO) |
Authorized Official Contact | 9105043506 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Recon Neurology & Psychiatry 764 Walnut Knoll Ln Cordova TN 38018-3113 Ph: (901) 756-5565 | Recon Neurology & Psychiatry 1340 Walter Reed Rd Ste 202 Fayetteville NC 28304-4451 Ph: (910) 504-3506 |
NPI Number | 1427769140 |
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Provider Enumeration Date | 12/13/2022 |
Last Update Date | 08/12/2024 |
Certification Date | 08/12/2024 |
Medicare PECOS PAC ID | 3870965924 |
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Medicare Enrollment ID | O20230217002468 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427769140 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Matthew Kyle Banks |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1659772069 PECOS PAC ID: 4082942750 Enrollment ID: I20190820002809 |
Provider Name | Ngu Wah Aung |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1760741961 PECOS PAC ID: 0941582076 Enrollment ID: I20190910000650 |
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