Organization
NEUROLOGY AND NEURODIAGNOSTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASHYAP PATEL MD (OWNER)
(912) 481-9945
Entity
Organization
Contact information
Practice address
1497 FAIR RD, STATESBORO, GA 30458-0822
(912) 486-1140
Mailing address
PO BOX 1639, STATESBORO, GA 30459
(912) 486-1140
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
64438
GA
Other
Enumeration date
05/12/2017
Last updated
08/24/2017
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