Provider Demographics
NPI:1437411576
Name:NORMAN, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:NORMAN
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:P.O. BOX 886
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460
Mailing Address - Country:US
Mailing Address - Phone:251-575-3111
Mailing Address - Fax:251-743-7445
Practice Address - Street 1:2016 S ALABAMA AVE STE C
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3044
Practice Address - Country:US
Practice Address - Phone:251-743-7555
Practice Address - Fax:251-743-7548
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.34681207Q00000X
IN11016801A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL192244Medicaid
IN000000946476OtherBCBS MEDPOINT
IN201112840Medicaid
IN201112840AMedicaid
IN201112840Medicaid
IN236040112Medicare PIN