MEDICARE: DR. JOHN THOMAS MORRIS III 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	207RN0300X	Nephrology Physician	MD29278	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00077021	OTHER	GA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1235185315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN THOMAS MORRIS III MD

Provider Business Mailing Address
First Line	:	780 TRUSE PKWY
Second Line	:	STE 102
City	:	MEMPHIS
State	:	TN
Zip	:	38117-5361
Country	:	US
Telephone Number	:	901-288-6255
Fax Number	:

Provider Business Practice Location Address
First Line	:	7640 WOLF RIVER CIR
Second Line	:	2ND FLOOR
City	:	MEMPHIS
State	:	TN
Zip	:	38138-1744
Country	:	US
Telephone Number	:	901-755-0208
Fax Number	:	901-767-3884

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	03/24/2020

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