| Wesley Neurology Clinic Pc | |
|
1211 Union Ave Ste 400 Memphis TN 38104 | |
| (901) 725-8920 | |
| (901) 725-8936 |
| Full Name | Wesley Neurology Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1211 Union Ave, Memphis, Tennessee |
| Authorized Official Name and Position | James R Lucas (ADMINISTRATOR) |
| Authorized Official Contact | 9017258920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesley Neurology Clinic Pc Po Box 1885 Memphis TN 38101-1885 Ph: (901) 725-8920 | Wesley Neurology Clinic Pc 1211 Union Ave Ste 400 Memphis TN 38104 Ph: (901) 725-8920 |
| NPI Number | 1437101821 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 09/26/2008 |
| Medicare PECOS PAC ID | 2264417740 |
|---|---|
| Medicare Enrollment ID | O20040619000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437101821 | NPI | - | NPPES |
| 3703205 | Medicaid | TN | |
| 09013571 | Medicaid | MS | |
| 122543002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Tulio E Bertorini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760459168 PECOS PAC ID: 4789662842 Enrollment ID: I20040713001528 |
| Provider Name | Rekha Pillai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356318752 PECOS PAC ID: 7416935598 Enrollment ID: I20040713001610 |
| Provider Name | Bola Adamolekun |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104816990 PECOS PAC ID: 4486617818 Enrollment ID: I20041108000257 |
| Provider Name | Hafiz A Elahi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689897159 PECOS PAC ID: 9335233519 Enrollment ID: I20070919000210 |
| Provider Name | Yaohui Chai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114140894 PECOS PAC ID: 4880725068 Enrollment ID: I20100702000229 |
| Provider Name | Nathan G. Lawrence |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346624327 PECOS PAC ID: 9436488061 Enrollment ID: I20190907000423 |
| Provider Name | Kayla Dawn Handy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154717262 PECOS PAC ID: 4284942483 Enrollment ID: I20200715001986 |
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