MOUNTAIN EMPIRE NEUROLOGICAL ASSOCIATES PC NPI 1114042629

NPI Information

  • NPI: 1114042629
  • Provider Name: MOUNTAIN EMPIRE NEUROLOGICAL ASSOCIATES PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 3183 W STATE ST
    SUITE 1201
    BRISTOL, TN
    ZIP 37620
  • Phone: (423) 761-0987

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NPI Details

MOUNTAIN EMPIRE NEUROLOGICAL ASSOCIATES PC is a specialist in Bristol, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MOUNTAIN EMPIRE NEUROLOGICAL ASSOCIATES PC NPI is 1114042629. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3183 W STATE ST
SUITE 1201
BRISTOL, TN
ZIP 37620-712
Phone: (423) 761-0987
Fax: (423) 652-2512

The provider's authorized official is Earl Keith Wilson .
The authorized official title is President and has the following contact phone number (423) 764-0987.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 6/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C04526MEDICARE PINVIRGINIA
2C04525MEDICARE PINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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