Healthcare Provider Details

I. General information

NPI: 1659376895
Provider Name (Legal Business Name): RICHARD F. NOREM II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2495 SHREVEPORT HWY
PINEVILLE LA
71360-4044
US

IV. Provider business mailing address

301 4TH ST
ALEXANDRIA LA
71301-8423
US

V. Phone/Fax

Practice location:
  • Phone: 318-473-0010
  • Fax:
Mailing address:
  • Phone: 318-448-1040
  • Fax: 318-448-0548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number020067
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberJ3862
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: