Provider Demographics
NPI:1669747671
Name:NORMAN A GARRISON MD LLC
Entity type:Organization
Organization Name:NORMAN A GARRISON MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-271-1739
Mailing Address - Street 1:9419 WINFIELD PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-5177
Mailing Address - Country:US
Mailing Address - Phone:334-271-1739
Mailing Address - Fax:
Practice Address - Street 1:9419 WINFIELD PL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-5177
Practice Address - Country:US
Practice Address - Phone:334-271-1739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13665207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty