Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 13391 | MA |
NPI | 1114131208 |
---|---|
Provider Name | Dr. Lonnie H Norris |
First Address | Boston, MA 02111-1527 |
Second Address | Boston, MA 02111-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013332 | NEIGHBORHOOD HEALTH (01) | MA |
013391 | TUFTS HEALTH (01) | MA |
0264679 | (05) | MA |
100969 | DELTA DENTAL (01) | MA |
16186NEMC | HARVARD (01) | MA |
4336614 | ATENA (01) | MA |
4651255 | CIGNA (01) | MA |