Provider Demographics
NPI:1952321994
Name:NORTON, CHARLES
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:NORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:
Other - Last Name:SNODGRASS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:512 POWELL AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-2346
Mailing Address - Country:US
Mailing Address - Phone:276-523-2889
Mailing Address - Fax:276-523-4488
Practice Address - Street 1:512 POWELL AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-2346
Practice Address - Country:US
Practice Address - Phone:276-523-2889
Practice Address - Fax:276-523-4488
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5626190001Medicare NSC