Organization Name: | MOUNTAIN EMPIRE NEUROLOGICAL ASSOCIATES PC |
NPI Number: | 1114042629 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EARL KEITH WILSON (PRESIDENT) |
Mailing Address: | 3183 W State St Suite 1201 Bristol |
State: | TN US |
Postal Code: | 376201712 |
Phone Number: | 4237610987 |
Fax Number: | 4236522512 |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 06/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |