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Contact Information

GENERAL AND VASCULAR SURGERY OF NORTHWEST ALABMA, INC.
15225 HIGHWAY 43 STE D
RUSSELLVILLE, AL35653-1969
 Phone: 256-332-1500
 Fax: 256-398-8888
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for GENERAL AND VASCULAR SURGERY OF NORTHWEST ALABMA, INC.

NPI # 1154639227
LBN Legal business name GENERAL AND VASCULAR SURGERY OF NORTHWEST ALABMA, INC.
Authorized official JEFFREY MANORD - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/22/2010
Last updated 03/29/2022 - About 4 years ago
Identifiers
AL License # 23436
AL Medicaid 126776
Other 511-17526 BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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