Basic Information
| Provider Information | |||||||||
| NPI: | 1154986636 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEUROSURGICAL ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 210127 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372210127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159861256 | ||||||||
| FaxNumber: | 6153830853 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 22ND AVE N | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153200007 | ||||||||
| FaxNumber: | 6153830853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2019 | ||||||||
| LastUpdateDate: | 05/09/2019 | ||||||||
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| AuthorizedOfficialLastName: | ULM | ||||||||
| AuthorizedOfficialFirstName: | ARTHUR | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6159861256 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEUROSURGICAL ASSOCIATES | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7726850001 | 01 | TN | NCS | OTHER |