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NPI Code Detail

MEDICARE: GARY M MORSE PH.D.

MEDICARE: GARY M MORSE PH.D.
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
1103TC0700XClinical Psychologist01217MO

General Provider Information

NPI Number : 1417966300
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY M MORSE PH.D.
Provider Business Mailing Address
First Line : 3738 CHOUTEAU AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2546
Country : US
Telephone Number : 314-772-8801
Fax Number : 314-772-7988
Provider Business Practice Location Address
First Line : 3738 CHOUTEAU AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2546
Country : US
Telephone Number : 314-772-8801
Fax Number : 314-772-7988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 07/08/2007

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