Provider Demographics
NPI:1982603262
Name:NEURO DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:NEURO DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELSHER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:228-385-1725
Mailing Address - Street 1:240 EISENHOWER DR
Mailing Address - Street 2:STE C-5
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-3654
Mailing Address - Country:US
Mailing Address - Phone:228-385-1725
Mailing Address - Fax:228-385-7366
Practice Address - Street 1:240 EISENHOWER DR
Practice Address - Street 2:STE C-5
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-3654
Practice Address - Country:US
Practice Address - Phone:228-385-1725
Practice Address - Fax:228-385-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5875079468OtherBCBS
MS5875079468OtherBCBS
13000123Medicare ID - Type Unspecified