Provider Demographics
NPI:1649334376
Name:NEUROSURGICAL ASSOCIATES
Entity type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:STRENTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-432-9515
Mailing Address - Street 1:2622 MEREDYTH DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-0206
Mailing Address - Country:US
Mailing Address - Phone:229-432-9515
Mailing Address - Fax:229-888-9520
Practice Address - Street 1:2622 MEREDYTH DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-0206
Practice Address - Country:US
Practice Address - Phone:229-432-9515
Practice Address - Fax:229-888-9520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOEBE PHYSICIAN GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045179207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG00947Medicare UPIN