Provider Demographics
NPI:1417993544
Name:NORMAN, SUZANNE ELAINE (DO)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELAINE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1656
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013-1656
Mailing Address - Country:US
Mailing Address - Phone:575-289-3291
Mailing Address - Fax:505-722-7470
Practice Address - Street 1:6349 US HIGHWAY 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013-6032
Practice Address - Country:US
Practice Address - Phone:505-289-3291
Practice Address - Fax:505-289-3390
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMA85087207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine