Provider Demographics
NPI:1831550854
Name:NOMA, PC
Entity type:Organization
Organization Name:NOMA, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:NORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-427-7888
Mailing Address - Street 1:111 STONEBRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2040
Mailing Address - Country:US
Mailing Address - Phone:731-427-7888
Mailing Address - Fax:731-265-4159
Practice Address - Street 1:111 STONEBRIDGE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3830
Practice Address - Country:US
Practice Address - Phone:731-427-7888
Practice Address - Fax:731-265-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty