Provider Demographics
NPI:1548241714
Name:NORWOOD, STEPHEN M (MD,)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:MD,
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 52194
Mailing Address - Street 2:DEPARTMENT 959
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85072-2194
Mailing Address - Country:US
Mailing Address - Phone:512-451-1969
Mailing Address - Fax:
Practice Address - Street 1:2500 W WILLIAM CANNON DR
Practice Address - Street 2:STE 401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5257
Practice Address - Country:US
Practice Address - Phone:512-451-1969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5435207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103854904Medicaid
TX8L18599Medicare PIN
TXE60279Medicare UPIN
TX8D8042Medicare PIN