1487497954 NPI number — KENT MCKOWEN MORRIS

Table of content: KENT MCKOWEN MORRIS (NPI 1487497954)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487497954 NPI number — KENT MCKOWEN MORRIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS
Provider First Name:
KENT
Provider Middle Name:
MCKOWEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1487497954
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4409 SAINT MARY ST
Provider Second Line Business Mailing Address:
13353 HWY 73 STE A GEISMAR, LA 70734
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-2027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-673-0000
Provider Business Mailing Address Fax Number:
225-673-1807

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13353 HIGHWAY 73 STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GEISMAR
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70734-3090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-673-0000
Provider Business Practice Location Address Fax Number:
225-673-1807
Provider Enumeration Date:
06/13/2024

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: 1223G0001X , with the licence number:  7841 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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