| Bluegrass Neurological Services, Psc | |
|
321 S 3rd St Suite A Danville KY 40422-2001 | |
| (859) 936-0094 | |
| (859) 936-0095 |
| Full Name | Bluegrass Neurological Services, Psc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 321 S 3rd St, Danville, Kentucky |
| Authorized Official Name and Position | Thomas W Johnson (OWNER) |
| Authorized Official Contact | 3175672180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Neurological Services, Psc 9899 E 126th St Fishers IN 46038-2821 Ph: (317) 567-2179 | Bluegrass Neurological Services, Psc 321 S 3rd St Suite A Danville KY 40422-2001 Ph: (859) 936-0094 |
| NPI Number | 1356447866 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 08/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356447866 | NPI | - | NPPES |
| 200378110 | Medicaid | IN | |
| 64069156 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 38102 (Kentucky) | Primary |
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