Healthcare Provider Details
I. General information
NPI: 1548456494
Provider Name (Legal Business Name): URGENT CARE NORTHWEST PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2007
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2708 HIGHWAY 78 E
JASPER AL
35501-3430
US
IV. Provider business mailing address
2708 HIGHWAY 78 E
JASPER AL
35501-3430
US
V. Phone/Fax
- Phone: 205-387-2253
- Fax: 205-387-2269
- Phone: 205-387-2253
- Fax: 205-387-2405
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEAN
ROBERT
NADEN
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: DO
Phone: 205-387-2253