Provider Demographics
NPI:1437268489
Name:MCCOOMER, NORMAN EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:EUGENE
Last Name:MCCOOMER
Suffix:
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 1:44 HUGHES RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-464-7855
Mailing Address - Fax:855-301-8314
Practice Address - Street 1:44 HUGHES RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-464-7855
Practice Address - Fax:855-301-8314
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060789A208100000X
AL29006174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200830700Medicaid
I35608Medicare UPIN