Provider Demographics
NPI:1922334945
Name:NORWOOD CLINIC, INC
Entity Type:Organization
Organization Name:NORWOOD CLINIC, INC
Other - Org Name:NORWOOD CLINIC IMAGING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-702-7555
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0230
Mailing Address - Country:US
Mailing Address - Phone:205-380-7878
Mailing Address - Fax:
Practice Address - Street 1:339 WALKER CHAPEL PLZ
Practice Address - Street 2:SUITE 101
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068-3402
Practice Address - Country:US
Practice Address - Phone:205-380-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty