Provider Demographics
NPI:1154433738
Name:NORFLEET, KENNETH RAY (RPH)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:RAY
Last Name:NORFLEET
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 54
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683
Mailing Address - Country:US
Mailing Address - Phone:423-388-9171
Mailing Address - Fax:352-796-6890
Practice Address - Street 1:1641 S. SHADY STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683
Practice Address - Country:US
Practice Address - Phone:423-727-0038
Practice Address - Fax:423-727-0039
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11435183500000X
TN0000004407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist