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NPI 1992362057

NPI 1992362057 : CHAD NORTON DO : FORT MOORE, GA

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General NPI Number Information
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    NPI Number           |    1992362057
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    Entity Type          |    Individual 
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    Provider Name        |    CHAD NORTON DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/23/2019
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    Last Update Date     |    08/30/2023
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Provider Practice Location Address
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    Address Line         |    6600 VAN AALST BLVD 
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    City                 |    FORT MOORE
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    State                |    GA
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    Zip                  |    31905-2102
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    Country              |    US
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    Telephone            |    762-408-2718
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6600 VAN AALST BLVD 
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    City                 |    FORT MOORE
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    State                |    GA
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    Zip                  |    31905-2102
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    Country              |    US
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    Telephone            |    762-408-2718
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    2294
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    License Number State |    NE
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Taxonomy #2
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    Taxonomy Code        |    207QS0010X
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    Taxonomy Name        |    Sports Medicine (Family Medicine) Physician
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    License Number       |    2294
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    License Number State |    NE
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