| Organization Name: | NEUROSURGICAL CLINIC OF BLOOMINGTON INC P.C. |
| NPI Number: | 1205821899 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARSHALL M. POOR (PRESIDENT) |
| Mailing Address: | 700 S College Ave Suite A Bloomington |
| State: | IN US |
| Postal Code: | 474032500 |
| Phone Number: | 8123318168 |
| Fax Number: | 8123311096 |
| NPI Enumeration Date: | 09/20/2005 |
| NPI Last Update Date: | 09/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 01039391 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| 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. |