MEDICARE: NWMC-WINFIELD PHYSICIAN PRACTICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1699859967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NWMC-WINFIELD PHYSICIAN PRACTICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 140
Second Line	:
City	:	DETROIT
State	:	AL
Zip	:	35552-0140
Country	:	US
Telephone Number	:	205-468-3355
Fax Number	:	205-468-3382

Provider Business Practice Location Address
First Line	:	65434 HIGHWAY 17
Second Line	:
City	:	DETROIT
State	:	AL
Zip	:	35552
Country	:	US
Telephone Number	:	205-468-3355
Fax Number	:	205-468-3382

Authorized Official
Title or Position	:	DIRECTOR OF CLINIC OPERATIONS
Name	:	GEORGE TSIMPIDES
Credential	:
Telephone Number	:	205-979-8861

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/22/2020

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