Provider Demographics
NPI:1093910705
Name:NORWOOD, GREGORY PEARCE (DO)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:PEARCE
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405827
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 SOUTHCREST CIR STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6719
Practice Address - Country:US
Practice Address - Phone:662-349-1112
Practice Address - Fax:662-349-6646
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21158207V00000X
TN2166207V00000X
MI5101016482207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology