Provider Demographics
NPI:1487335568
Name:NORRIS, JAMES WILLIE JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLIE
Last Name:NORRIS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24481 COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2526
Mailing Address - Country:US
Mailing Address - Phone:216-280-5615
Mailing Address - Fax:
Practice Address - Street 1:24481 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HTS
Practice Address - State:OH
Practice Address - Zip Code:44146-2526
Practice Address - Country:US
Practice Address - Phone:216-280-5615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRP925603171W00000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver