Organization
MEDGEN NEURO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNE GOSS (MANAGING MEMBER)
(999) 999-9999
Entity
Organization
Contact information
Practice address
824 N CREEK DR, CONWAY, AR 72032-4711
(999) 999-9999
Mailing address
824 N CREEK DR, CONWAY, AR 72032-4711
(999) 999-9999
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
12/15/2021
Last updated
01/17/2022
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