Healthcare Provider Details

I. General information

NPI: 1811994247
Provider Name (Legal Business Name): THOMAS F. NORBY FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MEDICAL CENTER DR STE 200
MEDFORD OR
97504-4314
US

IV. Provider business mailing address

520 MEDICAL CENTER DR STE 200
MEDFORD OR
97504-4314
US

V. Phone/Fax

Practice location:
  • Phone: 541-282-6606
  • Fax: 541-282-6601
Mailing address:
  • Phone: 541-282-6606
  • Fax: 541-282-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200050029
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number200050029NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: