MEDICARE: DR. NORMAN MORRIS SIMON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	11135	OK
2	207RG0100X	Gastroenterology Physician	11135	OK

General Provider Information

NPI Number	:	1215177415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN MORRIS SIMON M.D.

Provider Business Mailing Address
First Line	:	3519 S FLORENCE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-2909
Country	:	US
Telephone Number	:	918-749-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	3519 S FLORENCE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-2909
Country	:	US
Telephone Number	:	918-749-8889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2009
Last Update Date	:	02/27/2009

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