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General NPI Number Information
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NPI Number | 1306448394
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Entity Type | Organization
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Legal Business Name | NORTHWEST ALABAMA PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 20 MEDICAL CENTER DR STE 300
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City | JASPER
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State | AL
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Zip | 35501-3428
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Country | US
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Telephone | 205-384-0141
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Fax | 205-384-0171
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Provider Business Mailing Address
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Address Line | 20 MEDICAL CENTER DR STE 300
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City | JASPER
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State | AL
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Zip | 35501-3428
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Country | US
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Telephone | 205-384-0141
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Fax | 205-384-0171
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Authorized Official
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Title or Position | OWNER/PSYCHIATRIST
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Name | TERRY WAYNE BENTLEY
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Credential |
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Telephone | 205-384-0141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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