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Organization
GENERAL AND VASCULAR SURGERY OF NORTHWEST ALABMA, INC.
Active
Organization
GENERAL AND VASCULAR SURGERY OF NORTHWEST ALABMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY MANORD SR. (PRESIDENT)
(256) 332-1500
Entity
Organization
Contact information
Practice address
15225 HIGHWAY 43 STE D, RUSSELLVILLE, AL 35653-1969
(256) 332-1500
(256) 398-8888
Mailing address
PO BOX 660, RUSSELLVILLE, AL 35653-0616
(256) 332-1500
(256) 398-8888
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
23436
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126776
—
AL
01
—
511-17526
BCBS
—
Enumeration date
09/22/2010
Last updated
03/29/2022
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