Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1690 | AR |
NPI | 1992862619 |
---|---|
Provider Name | Dr. John Chance Norman |
First Address | Conway, AR 72034-3737 |
Second Address | Conway, AR 72034-3737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 25/03/2013 |