Basic Information
| Provider Information | |||||||||
| NPI: | 1871798892 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEANS | ||||||||
| FirstName: | NORMAN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 506 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ROCKFORD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458829228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193633008 | ||||||||
| FaxNumber: | 4193632093 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 E CHERRY ST | ||||||||
| Address2: | |||||||||
| City: | BLUFFTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467142002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2609193470 | ||||||||
| FaxNumber: | 2604792980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35130872 | OH | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 5269 | AK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207ZP0102X | 35130872 | OH | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 5269 | AK | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207Q00000X | 01081722A | IN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0233488 | 05 | OH | MEDICAID |