Healthcare Provider Details

I. General information

NPI: 1720003031
Provider Name (Legal Business Name): BRIAN BLAKE NORRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 LILE DR STE 600
LITTLE ROCK AR
72205-6225
US

IV. Provider business mailing address

9501 LILE DR STE 600
LITTLE ROCK AR
72205-6225
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7596
  • Fax: 501-978-1919
Mailing address:
  • Phone: 501-227-7596
  • Fax: 501-978-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberE2868
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberE2868
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: