Provider Demographics
NPI:1528028644
Name:NORRIS, JAMES TED JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TED
Last Name:NORRIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6831 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7865
Mailing Address - Country:US
Mailing Address - Phone:847-406-8213
Mailing Address - Fax:
Practice Address - Street 1:3001 6TH ST
Practice Address - Street 2:NAVAL HOSPITAL GREAT LAKES - DEPT OF ANESTHESIA
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2833
Practice Address - Country:US
Practice Address - Phone:847-688-5309
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology