Individual
DR. JUSTIN ROBERT NORTHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3535 S INTERSTATE 35 E, DENTON, TX 76210-6850
(940) 384-3535
Mailing address
9161 CEDAR RDG, LANTANA, TX 76226-4344
(952) 818-4083
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N8132
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
51416
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219337701
—
TX
05
—
219337702
—
TX
01
—
P00896830
RAILROAD
TX
Enumeration date
04/23/2007
Last updated
11/07/2011
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