Healthcare Provider Details

I. General information

NPI: 1215980297
Provider Name (Legal Business Name): NORVAL LEON BOOKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 NORTH 11TH AVE
BROKEN BOW NE
68822-1141
US

IV. Provider business mailing address

1245 NORTH 11TH AVE
BROKEN BOW NE
68822-1141
US

V. Phone/Fax

Practice location:
  • Phone: 308-872-6244
  • Fax:
Mailing address:
  • Phone: 308-872-6244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13347
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number016880
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: