Provider Demographics
NPI:1639615065
Name:NORRIS, JAMES DREW
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DREW
Last Name:NORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:DREW
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3714 GUARDIAN AVE
Mailing Address - Street 2:STE E
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2975
Mailing Address - Country:US
Mailing Address - Phone:252-222-5862
Mailing Address - Fax:
Practice Address - Street 1:3714 GUARDIAN AVE
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2974
Practice Address - Country:US
Practice Address - Phone:252-247-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06944363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical