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NPI Code Detail

MEDICARE: JACOB NORTON

MEDICARE:   JACOB  NORTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA.0008412CO
2363A00000XPhysician Assistant13665MN

Other Identifiers

General Provider Information

NPI Number : 1205412665
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB NORTON
Provider Business Mailing Address
First Line : 2312 N NEVADA AVE STE 235
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-5312
Country : US
Telephone Number : 719-998-0019
Fax Number : 719-325-5729
Provider Business Practice Location Address
First Line : 2312 N NEVADA AVE STE 235
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-5312
Country : US
Telephone Number : 719-998-0019
Fax Number : 719-325-5729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2021
Last Update Date : 01/28/2026

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Directions to “ JACOB NORTON ” Practice Location

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