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Individual

RANDALL GENE NORRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 SAINT CHARLES ST, JASPER, IN 47546
(812) 634-1211
(812) 634-1582
Mailing address
1900 SAINT CHARLES ST, JASPER, IN 47546
(812) 634-1211
(812) 634-1582

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01028986A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
215020B
MEDICARE GROUP #
IN
Enumeration date
03/30/2006
Last updated
02/05/2008
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