Healthcare Provider Details

I. General information

NPI: 1194008904
Provider Name (Legal Business Name): NWMC-WINFIELD PHYSICIAN PRACTICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 US HIGHWAY 43
WINFIELD AL
35594-5056
US

IV. Provider business mailing address

1530 US HIGHWAY 43
WINFIELD AL
35594-5056
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-7530
  • Fax: 205-487-7684
Mailing address:
  • Phone: 205-487-7530
  • Fax: 205-487-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: GEORGE TSIMPIDES
Title or Position: DIRECTOR OF CLINIC OPERATIONS
Credential:
Phone: 205-979-8861