Provider Demographics
NPI:1457724346
Name:BW PHYSICIAN PRACTICES, LLC
Entity Type:Organization
Organization Name:BW PHYSICIAN PRACTICES, LLC
Other - Org Name:BW PHYSICIAN PRACTICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, CFO TPR TENET
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2532
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:205-980-8099
Mailing Address - Fax:205-980-2606
Practice Address - Street 1:513 BROOKWOOD BLVD STE 260
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7844
Practice Address - Country:US
Practice Address - Phone:205-802-6595
Practice Address - Fax:205-802-6598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
102G700954Medicare PIN