Healthcare Provider Details

I. General information

NPI: 1235651241
Provider Name (Legal Business Name): HENRY C. NORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E RM 3C444
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

30 N 1900 E RM 3C444
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3622
  • Fax:
Mailing address:
  • Phone: 801-581-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11901391-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: