Provider Demographics
NPI:1063907210
Name:NORTON, ROBERT (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:NORTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 RIDGE AVE APT 5307
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1588
Mailing Address - Country:US
Mailing Address - Phone:215-301-2760
Mailing Address - Fax:
Practice Address - Street 1:8001 ROOSEVELT BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3010
Practice Address - Country:US
Practice Address - Phone:215-332-5300
Practice Address - Fax:215-332-5228
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006930213ES0131X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery