Healthcare Provider Details

I. General information

NPI: 1376507798
Provider Name (Legal Business Name): NORRIS & LOVE ORTHOPAEDIC & SPORTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SAINT CHARLES STREET
JASPER IN
47546-9145
US

IV. Provider business mailing address

1900 SAINT CHARLES STREET
JASPER IN
47546-9145
US

V. Phone/Fax

Practice location:
  • Phone: 812-634-1211
  • Fax: 812-634-9762
Mailing address:
  • Phone: 812-634-1211
  • Fax: 812-634-9762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDALL GENE NORRIS
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 812-634-1211