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General NPI Number Information
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NPI Number | 1811152853
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Entity Type | Organization
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Legal Business Name | NWMC WINFIELD PHYSICIAN PRACTICE
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 320 BANKHEAD HIGHWAY 43 SUITE 9
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City | WINFIELD
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State | AL
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Zip | 35594
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Country | US
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Telephone | 205-487-0511
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Fax | 205-487-0513
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | WINFIELD
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State | AL
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Zip | 35594-0726
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Country | US
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Telephone | 205-487-0511
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Fax | 205-487-0513
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Authorized Official
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Title or Position | CEO
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Name | MISS CHUCK SPANN
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Credential |
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Telephone | 205-487-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24217
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License Number State | AL
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