Provider Demographics
NPI:1972541985
Name:NORMAN, MICHAEL CRAIG (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CRAIG
Last Name:NORMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11106 DECIMAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2440
Mailing Address - Country:US
Mailing Address - Phone:025-554-3800
Mailing Address - Fax:502-614-6148
Practice Address - Street 1:11106 DECIMAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2440
Practice Address - Country:US
Practice Address - Phone:502-554-3800
Practice Address - Fax:502-614-6148
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002140A111N00000X
KY4847111N00000X
KY249068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100584900Medicaid