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General NPI Number Information
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NPI Number | 1548424757
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Entity Type | Organization
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Legal Business Name | NORTHWEST MEDICAL CENTER ASSOCIATION, INC.
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 402 E US HIGHWAY 136 NMC ALBANY CLINIC WEST
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City | ALBANY
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State | MO
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Zip | 64402-8210
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Country | US
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Telephone | 660-726-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 705 N COLLEGE ST NORTHWEST MEDICAL CENTER
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City | ALBANY
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State | MO
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Zip | 64402-1433
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Country | US
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Telephone | 660-726-3941
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Fax | 660-726-3647
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | DWIGHT CARVELL
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Credential |
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Telephone | 816-273-0437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 104860
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License Number State | MO
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