Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's ENT and Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY GAST (SYST VP OF MNGD CARE & PAYOR STRAT)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 272-5336
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5336
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
207Y00000X
Otolaryngology Physician
—
—
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
207YX0901X
Otology & Neurotology Physician
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
237700000X
Hearing Instrument Specialist
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/04/2019
Last updated
09/22/2021
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