Provider Demographics
NPI:1831124320
Name:CLEEK, NORRIS EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:NORRIS
Middle Name:EUGENE
Last Name:CLEEK
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 1096
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44901-1096
Mailing Address - Country:US
Mailing Address - Phone:530-332-5335
Mailing Address - Fax:530-893-6889
Practice Address - Street 1:1531 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3310
Practice Address - Country:US
Practice Address - Phone:530-332-5335
Practice Address - Fax:530-893-6889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA312912086S0127X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1831124320Medicaid
00A312910Medicare PIN
CA1831124320Medicaid