Provider Demographics
NPI:1760486609
Name:NORWOOD, WILLIAM LEWIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEWIS
Last Name:NORWOOD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3858
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71133-3858
Mailing Address - Country:US
Mailing Address - Phone:318-636-9905
Mailing Address - Fax:318-636-5102
Practice Address - Street 1:2751 ALBERT BICKNELL DRIVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3976
Practice Address - Country:US
Practice Address - Phone:318-636-9905
Practice Address - Fax:318-636-5102
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02605R208600000X
LAMD.02605R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA020048134OtherRR MEDICARE PROVIDER
TX119613103OtherPROVIDER NUMBER
LA1322881Medicaid
TX119613103OtherPROVIDER NUMBER
LA54377Medicare PIN