Provider Demographics
NPI:1972597383
Name:NORVELL, JAMES D (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:NORVELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BISHOP ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-1702
Mailing Address - Country:US
Mailing Address - Phone:606-528-1932
Mailing Address - Fax:606-523-9142
Practice Address - Street 1:121 BISHOP ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1702
Practice Address - Country:US
Practice Address - Phone:606-528-2953
Practice Address - Fax:606-523-9142
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000069985OtherANTHEM BCBS
KY90041187Medicaid
KY54010723Medicaid
KY000000069985OtherANTHEM BCBS