1881675213 NPI number — SCOTT E MORRIS DPM

Table of content: SCOTT E MORRIS DPM (NPI 1881675213)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881675213 NPI number — SCOTT E MORRIS DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS
Provider First Name:
SCOTT
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
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:
1881675213
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 S TELEPHONE RD
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
MOORE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73160-2942
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-794-6691
Provider Business Mailing Address Fax Number:
405-794-9856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 S TELEPHONE RD
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
MOORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73160-2942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-794-6691
Provider Business Practice Location Address Fax Number:
405-794-9856
Provider Enumeration Date:
11/11/2005

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: 213E00000X , with the licence number:  240 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200106920A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".