Provider Demographics
NPI:1750549119
Name:POYNTER, NORLEENA RENE (MD)
Entity type:Individual
Prefix:DR
First Name:NORLEENA
Middle Name:RENE
Last Name:POYNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NORLEENA
Other - Middle Name:RENE
Other - Last Name:GULLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1912 HAYES AVE STE 1E
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4736
Mailing Address - Country:US
Mailing Address - Phone:419-557-5594
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:701 TYLER ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3321
Practice Address - Country:US
Practice Address - Phone:419-557-7480
Practice Address - Fax:419-557-7533
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN522272085R0001X
OH35.1436362085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018558Medicaid