Provider Demographics
NPI:1124246566
Name:NORBURY, JOHN W III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:NORBURY
Suffix:III
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 1:3601 4TH ST STOP 8321
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8321
Mailing Address - Country:US
Mailing Address - Phone:806-743-2391
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST STOP 8321
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-7503
Practice Address - Country:US
Practice Address - Phone:806-743-2391
Practice Address - Fax:806-743-5687
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101283929208100000X
TXT22342081N0008X, 208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC159P3OtherBCBSNC
NC5915602Medicaid
NC5915602Medicaid