MEDICARE: JED LANE MORRIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	03455R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00143410	OTHER	LA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235139833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JED LANE MORRIS MD

Provider Business Mailing Address
First Line	:	PO BOX 4869
Second Line	:	DEPARTMENT 235
City	:	HOUSTON
State	:	TX
Zip	:	77210-4869
Country	:	US
Telephone Number	:	877-744-1141
Fax Number	:	847-537-4866

Provider Business Practice Location Address
First Line	:	3401 NORTH BLVD
Second Line	:	SUITE 200
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-3743
Country	:	US
Telephone Number	:	225-387-0851
Fax Number	:	225-383-8477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	02/14/2012

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