| Springfield Neurology | |
|
107 Tennessee St Bolivar TN 38008-1822 | |
| (615) 384-2411 | |
| Not Available |
| Full Name | Springfield Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 107 Tennessee St, Bolivar, Tennessee |
| Authorized Official Name and Position | Todd E Rutland (OWNER) |
| Authorized Official Contact | 6153841740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Springfield Neurology Po Box 190 Middleton TN 38052-0190 Ph: () - | Springfield Neurology 107 Tennessee St Bolivar TN 38008-1822 Ph: (615) 384-2411 |
| NPI Number | 1629408059 |
|---|---|
| Provider Enumeration Date | 11/21/2013 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 1052652666 |
|---|---|
| Medicare Enrollment ID | O20190409001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629408059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 40556 (Tennessee) | Primary |
| Provider Name | Todd E Rutland |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942249206 PECOS PAC ID: 8527072370 Enrollment ID: I20060131000713 |
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