Provider Demographics
NPI:1972505535
Name:NORWOOD, WAYLAND REED (AUD)
Entity Type:Individual
Prefix:DR
First Name:WAYLAND
Middle Name:REED
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 S JEFFERSON AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-4278
Mailing Address - Country:US
Mailing Address - Phone:931-854-9499
Mailing Address - Fax:931-854-9460
Practice Address - Street 1:728 S JEFFERSON AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4278
Practice Address - Country:US
Practice Address - Phone:931-854-9499
Practice Address - Fax:931-854-9460
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4325303OtherBCBS TENNESSEE
TN3192384Medicaid
4325303OtherBCBS TENNESSEE