Provider Demographics
NPI:1699982546
Name:MID-SOUTH NEUROLOGICAL CLINIC INC
Entity type:Organization
Organization Name:MID-SOUTH NEUROLOGICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:FEILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-757-4199
Mailing Address - Street 1:234 GERMANTOWN BEND CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7237
Mailing Address - Country:US
Mailing Address - Phone:901-757-4199
Mailing Address - Fax:901-757-8273
Practice Address - Street 1:234 GERMANTOWN BEND CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7237
Practice Address - Country:US
Practice Address - Phone:901-757-4199
Practice Address - Fax:901-757-8273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3113138Medicare PIN