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Contact Information

HEADWAY NEURO, PLLC
3889 COBB PKWY NW
ACWORTH, GA30101-4084
 Phone: 404-665-3149
 Fax: 404-665-3149
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for HEADWAY NEURO, PLLC

NPI # 1164387106
LBN Legal business name HEADWAY NEURO, PLLC
Authorized official BRANDON MINES - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/22/2025
Last updated 12/22/2025 - About 5 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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