| Livingspring Neurology Center Llc | |
|
109 Harrigan Way Yorktown VA 23693-5609 | |
| (757) 598-2123 | |
| Not Available |
| Full Name | Livingspring Neurology Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 109 Harrigan Way, Yorktown, Virginia |
| Authorized Official Name and Position | Olubusola Amiola (PROVIDER) |
| Authorized Official Contact | 7575982123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingspring Neurology Center Llc 109 Harrigan Way Yorktown VA 23693-5609 Ph: (757) 598-2123 | Livingspring Neurology Center Llc 109 Harrigan Way Yorktown VA 23693-5609 Ph: (757) 598-2123 |
| NPI Number | 1093581399 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 6204272834 |
|---|---|
| Medicare Enrollment ID | O20240306000924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093581399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Olubusola Amiola |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437503323 PECOS PAC ID: 6305162041 Enrollment ID: I20210614001797 |
| Provider Name | Tolulope O Amiola |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952807463 PECOS PAC ID: 9234513425 Enrollment ID: I20230915000922 |
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