Healthcare Provider Details

I. General information

NPI: 1295863272
Provider Name (Legal Business Name): RODNEY A NORMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 W WACKERLY ST STE 200
MIDLAND MI
48640-4724
US

IV. Provider business mailing address

1005 S US HIGHWAY 27 STE 100
SAINT JOHNS MI
48879-2423
US

V. Phone/Fax

Practice location:
  • Phone: 989-224-3000
  • Fax: 989-668-0423
Mailing address:
  • Phone: 989-224-3000
  • Fax: 989-668-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601003990
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: