Healthcare Provider Details

I. General information

NPI: 1033420344
Provider Name (Legal Business Name): RYAN GLENN MCMORRIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 AL HIGHWAY 157
CULLMAN AL
35058-0609
US

IV. Provider business mailing address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-2000
  • Fax:
Mailing address:
  • Phone: 330-493-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP5208
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number22014
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: