Provider Demographics
NPI:1588323000
Name:NORSWETHER, PHILIP COREY
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:COREY
Last Name:NORSWETHER
Suffix:
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 1:5358 CALDER WAY APT 520
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1767
Mailing Address - Country:US
Mailing Address - Phone:317-520-6681
Mailing Address - Fax:
Practice Address - Street 1:830 OSWEGO RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2643
Practice Address - Country:US
Practice Address - Phone:765-714-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty