Provider Demographics
NPI:1275855355
Name:NORMAN, CAROLINE ROBERTS (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:ROBERTS
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LLANSFAIR DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-8419
Mailing Address - Country:US
Mailing Address - Phone:337-303-8834
Mailing Address - Fax:337-406-2403
Practice Address - Street 1:110 LLANSFAIR DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-8419
Practice Address - Country:US
Practice Address - Phone:337-303-8834
Practice Address - Fax:337-406-2403
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13278R207R00000X
MS09645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine