Organization
NEUROLOGY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE ROSE ANSELL MD (SOLE PROPRIETOR)
(931) 905-4144
Entity
Organization
Contact information
Practice address
1750 MEMORIAL DR, SUITE C, CLARKSVILLE, TN 37043-6356
(931) 905-4144
(931) 905-4143
Mailing address
2000 QUEENS BLUFF WAY, CLARKSVILLE, TN 37043-4858
(931) 905-4144
(931) 905-4143
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
41086
TN
2084N0400X
Neurology Physician
Primary
41086
TN
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
41086
TN
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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