Organization
SOUTHWEST NEUROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEMPSAGER C RAVISHANKAR MD (PHYSICIAN)
(440) 826-9221
Entity
Organization
Contact information
Practice address
7215 OLD OAK BLVD, A411, CLEVELAND, OH 44130-3340
(440) 826-9221
(440) 816-5399
Mailing address
7215 OLD OAK BLVD, A411, CLEVELAND, OH 44130-3340
(440) 826-9221
(440) 816-5399
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
35068631
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500150
UNITED HEATHCARE INS
OH
05
—
0946169
—
OH
01
—
108691
KAISER INS
OH
01
—
1579165
CIGNA
OH
01
—
203918
ANTHEM
OH
01
—
7543555
AETNA INS
OH
01
—
P00036566
MEDICARE RAILROAD
OH
Enumeration date
10/21/2007
Last updated
12/08/2017
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