Provider Demographics
NPI:1659666311
Name:NORWOOD, JAMES R
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1378 STONELEIGH HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-5651
Mailing Address - Country:US
Mailing Address - Phone:404-993-0546
Mailing Address - Fax:
Practice Address - Street 1:2890 GEORGIA HIGHWAY 212 SW
Practice Address - Street 2:STE A-203
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-3363
Practice Address - Country:US
Practice Address - Phone:770-734-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048641186343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle