MEDICARE: DR. DEREK F NORCOM MD

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
1	207Q00000X	Family Medicine Physician	MD21044	OR
2	207Q00000X	Family Medicine Physician	67415	TN
3	207Q00000X	Family Medicine Physician	43670	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326087263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK F NORCOM MD

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	629-224-1621
Fax Number	:

Provider Business Practice Location Address
First Line	:	7313 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2007
Country	:	US
Telephone Number	:	405-251-8884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	10/25/2024

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