Provider Demographics
NPI:1679592224
Name:NORTON, J RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:RUSSELL
Last Name:NORTON
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:PO BOX 366
Mailing Address - Street 2:202 TAUGHANNOCK BLVD
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14851-0001
Mailing Address - Country:US
Mailing Address - Phone:607-277-4035
Mailing Address - Fax:607-277-3888
Practice Address - Street 1:101 DATES DRIVE
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-0001
Practice Address - Country:US
Practice Address - Phone:607-274-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211785207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00025561501OtherUNIVERA
NY7022228OtherAETNA
NYG0189393590OtherBLUE CHOICE GROUP
NY5399002OtherGHI
NY00372225Medicaid
NY02173191Medicaid
NY2222OtherBLUE SHIELD GROUP
NYMDG269OtherPREFERRED CARE
NY000918689001OtherBS WNY/HEALTHNOW
NY050080581OtherRAILROAD MEDICARE
NYP101211785OtherBLUE CHOICE
NY000918689001OtherBS WNY/HEALTHNOW
NY050080581OtherRAILROAD MEDICARE
NY2222OtherBLUE SHIELD GROUP
NY00025561501OtherUNIVERA