Provider Demographics
NPI:1265628630
Name:NORMINGTON, RICHARD V (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:V
Last Name:NORMINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2 CONCOURSE PKWY NE
Mailing Address - Street 2:STE 245
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 CONCOURSE PKWY NE
Practice Address - Street 2:STE 245
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5371
Practice Address - Country:US
Practice Address - Phone:800-366-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA204482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A22169Medicare UPIN