Healthcare Provider Details

I. General information

NPI: 1407436736
Provider Name (Legal Business Name): JACQUELINE MORRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N 20TH ST STE 3
OPELIKA AL
36801-5454
US

IV. Provider business mailing address

121 N 20TH ST STE 3
OPELIKA AL
36801-5454
US

V. Phone/Fax

Practice location:
  • Phone: 334-745-6271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD.53756
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: