Provider Demographics
NPI:1568421196
Name:NORFLEET, THOMAS WAYNE (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WAYNE
Last Name:NORFLEET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 TRAXLER CT
Mailing Address - Street 2:STE 100
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706
Mailing Address - Country:US
Mailing Address - Phone:989-684-7121
Mailing Address - Fax:989-684-7677
Practice Address - Street 1:3741 TRAXLER CT
Practice Address - Street 2:STE 100
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-684-7121
Practice Address - Fax:989-684-7677
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003712152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI944359728Medicaid
U52099Medicare UPIN
N3975001MIMedicare ID - Type Unspecified