# M & G NEUROPHYSIOLOGY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225166903
- **Authorized official:** MICHAEL DAVID MILLER (PRESIDENT)
- **Authorized official phone:** (606) 923-8504

## Contact information

- **Practice address:** 4338 13TH ST, ASHLAND, KY 41102-5432
- **Practice address phone:** (606) 585-0888
- **Mailing address:** 4338 13TH ST, ASHLAND, KY 41102-5432
- **Mailing address phone:** (606) 585-0888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 01/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810002260 | — | WV |
| 05 | — | 65943573 | — | KY |
| 01 | — | P00234784 | RAIL ROAD MC | KY |