Provider Demographics
NPI:1285766428
Name:ANDERSON NEUROLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:ANDERSON NEUROLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-226-7636
Mailing Address - Street 1:2000 EAST GREENVILLE STREET
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-226-7636
Mailing Address - Fax:864-231-7743
Practice Address - Street 1:2000 EAST GREENVILLE STREET
Practice Address - Street 2:SUITE 2800
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-226-7636
Practice Address - Fax:864-231-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2112Medicaid
SC2112Medicaid