Provider Demographics
NPI:1114792694
Name:NEURO LOGIC PLLC
Entity type:Organization
Organization Name:NEURO LOGIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:B
Authorized Official - Last Name:AL-HAMDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-444-2644
Mailing Address - Street 1:PO BOX 381195
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-1195
Mailing Address - Country:US
Mailing Address - Phone:901-444-2644
Mailing Address - Fax:901-333-7770
Practice Address - Street 1:3000 GETWELL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2299
Practice Address - Country:US
Practice Address - Phone:901-444-2644
Practice Address - Fax:901-333-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty