MEDICARE: JOHN A MORRIS DC PA

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	111N00000X	Chiropractor	CH8378	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34769 GROUP NUMBER	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1588779235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN A MORRIS DC PA

Provider Business Mailing Address
First Line	:	333 5TH AVE N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-5611
Country	:	US
Telephone Number	:	904-241-7907
Fax Number	:	904-241-1401

Provider Business Practice Location Address
First Line	:	333 5TH AVE N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-5611
Country	:	US
Telephone Number	:	904-241-7907
Fax Number	:	904-241-1401

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CASEY G MORRIS
Credential	:
Telephone Number	:	904-241-7907

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	06/25/2012

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Directions to “JOHN A MORRIS DC PA ” Practice Location

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