| Southwest Neurodiagnostics Llc | |
|
42104 N Venture Dr Ste A114 Anthem AZ 85086-3825 | |
| (602) 395-0718 | |
| (602) 277-8146 |
| Full Name | Southwest Neurodiagnostics Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 42104 N Venture Dr Ste A114, Anthem, Arizona |
| Authorized Official Name and Position | Cody D Davies (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 4065994354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Neurodiagnostics Llc 42104 N Venture Dr Ste A114 Anthem AZ 85086-3825 Ph: (406) 599-4354 | Southwest Neurodiagnostics Llc 42104 N Venture Dr Ste A114 Anthem AZ 85086-3825 Ph: (602) 395-0718 |
| NPI Number | 1669969564 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 11/30/2020 |
| Certification Date | 11/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669969564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 246ZE0500X | Specialist/technologist, Other - Eeg | (* (Not Available)) | Secondary |
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