Provider Demographics
NPI:1548456494
Name:URGENT CARE NORTHWEST PC
Entity type:Organization
Organization Name:URGENT CARE NORTHWEST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:NADEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:205-387-2253
Mailing Address - Street 1:2708 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3430
Mailing Address - Country:US
Mailing Address - Phone:205-387-2253
Mailing Address - Fax:205-387-2405
Practice Address - Street 1:2708 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3430
Practice Address - Country:US
Practice Address - Phone:205-387-2253
Practice Address - Fax:205-387-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL186249Medicaid
ALDG9096OtherRAILROAD MEDICARE
510G700064Medicare PIN