Provider Demographics
NPI:1902937824
Name:PAMELA QUINN MD MPH NEUROLOGY PC
Entity Type:Organization
Organization Name:PAMELA QUINN MD MPH NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-753-4345
Mailing Address - Street 1:7633 AL HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-7137
Mailing Address - Country:US
Mailing Address - Phone:256-753-4345
Mailing Address - Fax:256-753-3010
Practice Address - Street 1:7633 AL HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7137
Practice Address - Country:US
Practice Address - Phone:256-753-4345
Practice Address - Fax:256-753-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000217582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529905750Medicaid