1124118567 NPI number — ALAN MORRISON DO LLC

Table of content: (NPI 1124118567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124118567 NPI number — ALAN MORRISON DO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAN MORRISON DO LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1124118567
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5410 CONNECTICUT AVE NW
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20015-2859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-966-0622
Provider Business Mailing Address Fax Number:
202-966-0977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5410 CONNECTICUT AVE NW
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20015-2859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-966-0622
Provider Business Practice Location Address Fax Number:
202-966-0977
Provider Enumeration Date:
10/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORRISON
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
202-966-0622

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  DO30247 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2129796 . This is a "MAMSI/UNITED" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 3644009 . This is a "AETNA HMO" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: J36AAR . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 688740 . This is a "NCPPO" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 036367700 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4739368 . This is a "CIGNA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 7530170 . This is a "AETNA PPO" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: J682 . This is a "BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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