Provider Demographics
NPI:1538598594
Name:NORRIS, CRAIG (PA - C)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:NORRIS
Suffix:
Gender:M
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 W WHEELER PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1899
Mailing Address - Country:US
Mailing Address - Phone:706-869-9222
Mailing Address - Fax:706-869-1527
Practice Address - Street 1:1219 W WHEELER PKWY STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1899
Practice Address - Country:US
Practice Address - Phone:706-869-9222
Practice Address - Fax:706-869-1527
Is Sole Proprietor?:No
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007039363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical