Provider Demographics
NPI:1700067907
Name:NWMC WINFIELD PHYSICIAN PRACTICES DBA NORTHWEST ENT CONSULTANTS
Entity Type:Organization
Organization Name:NWMC WINFIELD PHYSICIAN PRACTICES DBA NORTHWEST ENT CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-487-7536
Mailing Address - Street 1:200 CARRWAY DRIVE SUITE B1
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594
Mailing Address - Country:US
Mailing Address - Phone:205-487-7536
Mailing Address - Fax:205-487-7539
Practice Address - Street 1:200 CARRWAY DRIVE SUITE B1
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594
Practice Address - Country:US
Practice Address - Phone:205-487-7536
Practice Address - Fax:205-487-7539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NWMC WINFIELD PHYSICIAN PRACTICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-16
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26928207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty