Organization
ADVANCED NEUROSURGERY LLC
Active
Other names
Advanced Neurosurgery
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WASHINGTON (VICE PRESIDENT)
(703) 650-2907
Entity
Organization
Contact information
Practice address
3903 S 7TH ST, SUITE 1D, TERRE HAUTE, IN 47802-5710
(812) 234-0787
(812) 232-3253
Mailing address
3903 S 7TH ST, SUITE 1D, TERRE HAUTE, IN 47802-5710
(812) 234-0787
(812) 232-3253
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01026616A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200844940A
—
IN
Enumeration date
10/03/2006
Last updated
09/11/2008
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