Organization
M & G NEUROPHYSIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID MILLER (PRESIDENT)
(606) 923-8504
Entity
Organization
Contact information
Practice address
4338 13TH ST, ASHLAND, KY 41102-5432
(606) 585-0888
Mailing address
4338 13TH ST, ASHLAND, KY 41102-5432
(606) 585-0888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002260
—
WV
05
—
65943573
—
KY
01
—
P00234784
RAIL ROAD MC
KY
Enumeration date
03/02/2007
Last updated
01/08/2024
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