Individual
DR. JONATHAN PAUL NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
265 N 3RD E, MOUNTAIN HOME, ID 83647-2734
(208) 587-8415
(208) 587-8416
Mailing address
PO BOX 39, MOUNTAIN HOME, ID 83647-0039
(208) 587-8415
(208) 587-8416
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100171
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808220800
—
ID
Enumeration date
07/28/2008
Last updated
04/10/2015
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