Doctor Name: | DR. JOHN NORRIS DESVERREAUX |
NPI Number: | 1134126113 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 00013917 |
Business Practice Address: | 1613 N Mckenzie St Foley, AL - 365352247 |
Business Phone Number: | 2519655393 |
Business Fax Number: | 2519711029 |
Mailing Address: | Po Box 1028, MAGNOLIA SPRINGS |
State: | AL |
Postal Code: | 365551028 |
Phone Number: | 2519655393 |
Fax Number: | 2519711029 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 00013917 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |