Provider Demographics
NPI:1427324094
Name:BRIAN J NORKIEWICZ MD PA
Entity type:Organization
Organization Name:BRIAN J NORKIEWICZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NORKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-771-3680
Mailing Address - Street 1:3711 22ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1303
Mailing Address - Country:US
Mailing Address - Phone:806-771-3680
Mailing Address - Fax:806-771-3678
Practice Address - Street 1:3711 22ND ST STE C
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1303
Practice Address - Country:US
Practice Address - Phone:806-771-3680
Practice Address - Fax:806-771-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4395208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty