TRI-STATE NEUROLOGY PLLC NPI 1184788762

NPI Information

NPI: 1184788762
Provider Name: TRI-STATE NEUROLOGY PLLC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
5100 SANDERLIN AVE STE 2100
MEMPHIS, TN
ZIP 38117
Phone: (901) 820-0141
Get Directions

TRI-STATE NEUROLOGY PLLC is a neurology psychiatry neurology in Memphis, TN. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. TRI-STATE NEUROLOGY PLLC NPI is 1184788762. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5100 SANDERLIN AVE STE 2100
MEMPHIS, TN
ZIP 38117-387
Phone: (901) 820-0141
Fax: (901) 820-0144

The provider's authorized official is James J Wang .
The authorized official title is President / Owner and has the following contact phone number (901) 820-0141.

The enumeration date for this NPI number is 12/20/2006 and was last updated on 11/30/2017.

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
1	2084N0400X	Psychiatry & Neurology	Neurology	MD0000030878	TENNESSEE	Yes

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
1	G90645	MEDICARE UPIN	TENNESSEE
2	3838091	MEDICAID	TENNESSEE
3	3838091	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE
4	138488001	MEDICAID	ARKANSAS
5	00126261	MEDICAID	MISSISSIPPI
6	206187502	MEDICAID	MISSOURI

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: 5/5/2024

NPI Synchronization or Removal

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