Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | DS017219L | PA |
NPI | 1093708372 |
---|---|
Provider Name | Dr. Ernest Y. Normington III |
First Address | Lewisburg, PA 17837-9367 |
Second Address | Lewisburg, PA 17837-9367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 15/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E52204 | (02) |