Provider Demographics
NPI:1932183845
Name:NORRIS, ROBERT JAMES (DO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JAMES
Last Name:NORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 MOUNT VERNON HIGHWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-419-4700
Mailing Address - Fax:
Practice Address - Street 1:755 MOUNT VERNON HIGHWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-419-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001539207Q00000X
GA54819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00040221OtherRR MEDICARE
GA767068677AMedicaid
NC89066VEMedicaid
TN3307782Medicaid
P00040221OtherRR MEDICARE
TN3307782Medicare ID - Type Unspecified