Provider Demographics
NPI:1467739870
Name:TOTAL PERFORMANCE MEDICINE
Entity Type:Organization
Organization Name:TOTAL PERFORMANCE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:NORTICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-553-5111
Mailing Address - Street 1:535 JACK WARNER PKWY NE
Mailing Address - Street 2:SUITE J-1
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5751
Mailing Address - Country:US
Mailing Address - Phone:205-553-5111
Mailing Address - Fax:
Practice Address - Street 1:535 JACK WARNER PKWY NE
Practice Address - Street 2:SUITE J-1
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5751
Practice Address - Country:US
Practice Address - Phone:205-553-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16195208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty