Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 078142022 | TN |
NPI | 1083877336 |
---|---|
Provider Name | Mr. Joel Edward Norman |
First Address | Knoxville, TN 37916-2434 |
Second Address | Knoxville, TN 37916-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 24/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1531065 | (05) | TN |