MEDICARE: DR. JOSHUA JACOB 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	207P00000X	Emergency Medicine Physician	M-11763	ID
2	207Q00000X	Family Medicine Physician	M-11763	ID

General Provider Information

NPI Number	:	1619173143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA JACOB MORRIS MD

Provider Business Mailing Address
First Line	:	10620 HIGHWAY 12
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-9372
Country	:	US
Telephone Number	:	208-476-3158
Fax Number	:	208-476-5385

Provider Business Practice Location Address
First Line	:	10620 HIGHWAY 12
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-9372
Country	:	US
Telephone Number	:	208-476-3158
Fax Number	:	208-476-5385

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	10/29/2024

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