Provider Demographics
NPI:1790836781
Name:NORWOOD SURGICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:NORWOOD SURGICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:318-636-9905
Mailing Address - Street 1:P.O. BOX 3858
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71133-3858
Mailing Address - Country:US
Mailing Address - Phone:318-636-9905
Mailing Address - Fax:318-636-5102
Practice Address - Street 1:2751 ALBERT BICKNELL DRIVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3976
Practice Address - Country:US
Practice Address - Phone:318-636-9905
Practice Address - Fax:318-636-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1440388Medicaid
TX078721002Medicaid
LA1440388Medicaid
LACB2531Medicare UPIN
TX078721002Medicaid