Organization
NEURO-EVAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA BENTON (OFFICE MANAGER)
(334) 677-6425
Entity
Organization
Contact information
Practice address
105 N PONTIAC AVE, SUITE 1, DOTHAN, AL 36303-3959
(334) 677-6425
(334) 677-6921
Mailing address
105 N PONTIAC AVE, SUITE 1, DOTHAN, AL 36303-3959
(334) 677-6425
(334) 677-6921
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10583
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51089293
BCBS AL
AL
Enumeration date
07/07/2006
Last updated
08/22/2020
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