1336192624 NPI number — DR. AMY B NORTON M.D.

Table of content: DR. AMY B NORTON M.D. (NPI 1336192624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336192624 NPI number — DR. AMY B NORTON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORTON
Provider First Name:
AMY
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336192624
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 N 6TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKSBURG
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26301-2665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-624-7200
Provider Business Mailing Address Fax Number:
304-554-0404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
165 SCOTT AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26508-8847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-554-0400
Provider Business Practice Location Address Fax Number:
304-554-0404
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  21773 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207N00000X , with the licence number: MD428812 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810006178 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102129866 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com