Organization
COMPREHENSIVE NEUROLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM HOGANCAMP M.D. (OWNER)
(270) 575-9990
Entity
Organization
Contact information
Practice address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 575-9990
(270) 575-9950
Mailing address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 575-9990
(270) 575-9950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32561
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323921
ANTHEM BC/BS
KY
01
—
05156
RAILROAD MEDICARE GROUP #
KY
05
—
64325616
—
KY
01
—
65940652
MEDICAID GROUP NUMBER
KY
01
—
9060
MEDICARE GROUP NUMBER
KY
01
—
P00110715
RAILROAD MEDICARE NUMBER
KY
Enumeration date
01/09/2007
Last updated
12/30/2009
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