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General NPI Number Information
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NPI Number | 1023204062
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Entity Type | Organization
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Legal Business Name | NORTHWEST PHYSICIANS, LLC
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 601 W MAPLE AVE SUITE 505
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-757-5354
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 COMMERCE WAY SUITE 180
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City | BRENTWOOD
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State | TN
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Zip | 37027-2829
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Country | US
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Telephone | 615-465-7626
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PROVIDER ENROLLMENT
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Name | DEBBIE T BREWER
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Credential |
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Telephone | 615-465-7626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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