Provider Demographics
NPI:1811152853
Name:NWMC WINFIELD PHYSICIAN PRACTICE
Entity type:Organization
Organization Name:NWMC WINFIELD PHYSICIAN PRACTICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-487-0511
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-0726
Mailing Address - Country:US
Mailing Address - Phone:205-487-0511
Mailing Address - Fax:205-487-0513
Practice Address - Street 1:320 BANKHEAD HIGHWAY 43
Practice Address - Street 2:SUITE 9
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594
Practice Address - Country:US
Practice Address - Phone:205-487-0511
Practice Address - Fax:205-487-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL242172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH52024Medicare UPIN