Provider Demographics
NPI:1619935129
Name:NORRIS, JOHN WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:NORRIS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:508 SOUTHARD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6989
Mailing Address - Country:US
Mailing Address - Phone:305-296-1022
Mailing Address - Fax:305-296-5828
Practice Address - Street 1:508 SOUTHARD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-6989
Practice Address - Country:US
Practice Address - Phone:305-296-1022
Practice Address - Fax:305-296-5828
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-11-23
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Provider Licenses
StateLicense IDTaxonomies
FLME91477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271591100Medicaid
FL64365ZMedicare PIN
FLF27283Medicare UPIN