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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