Provider Demographics
NPI:1679556989
Name:NORA, FREDERICK E (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:E
Last Name:NORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5052 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1069
Mailing Address - Country:US
Mailing Address - Phone:601-268-5995
Mailing Address - Fax:601-261-3201
Practice Address - Street 1:5052 W 4TH ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1069
Practice Address - Country:US
Practice Address - Phone:601-268-5995
Practice Address - Fax:601-261-3201
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18068207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07802313Medicaid
MSP00448955OtherMEDICARE RAILROAD
MSP00448955OtherMEDICARE RAILROAD
MS220000227Medicare PIN