1447233044 NPI number — DR. KIRK D. MORRISON DC, DABCO

Table of content: LAWRENCE MARK GLANZ PH D (NPI 1881657112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447233044 NPI number — DR. KIRK D. MORRISON DC, DABCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRISON
Provider First Name:
KIRK
Provider Middle Name:
D.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC, DABCO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447233044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
209 E LEWIS AND CLARK PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47129-1723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-941-9930
Provider Business Mailing Address Fax Number:
812-941-9940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 E LEWIS AND CLARK PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47129-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-941-9930
Provider Business Practice Location Address Fax Number:
812-941-9940
Provider Enumeration Date:
11/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  08001243A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111NX0800X , with the licence number: 08001243A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 350034998 . This is a "RRMR" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 351955373100 . This is a "CARESOURCE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 214844100 . This is a "ACS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000042675 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 100076550A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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