Organization
NORRIS VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA MARIE NORRIS OD (OWNER)
(270) 640-7670
Entity
Organization
Contact information
Practice address
14800 FORT CAMPBELL BLVD, OAK GROVE, KY 42262-8304
(270) 640-7670
Mailing address
14800 FORT CAMPBELL BLVD, OAK GROVE, KY 42262-8304
(270) 640-7670
(270) 640-3651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1761DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031419496
MEDICARE NUMBER
KY
01
—
1975101
MEDICARE PTAN
KY
05
—
7100113250
—
KY
Enumeration date
01/20/2011
Last updated
01/20/2011
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