Healthcare Provider Details

I. General information

NPI: 1790715720
Provider Name (Legal Business Name): ANDREW JEREMIAH MORSE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W OTTLEY AVE
FRUITA CO
81521-2118
US

IV. Provider business mailing address

PO BOX 130
FRUITA CO
81521-0130
US

V. Phone/Fax

Practice location:
  • Phone: 970-858-3900
  • Fax: 970-858-2202
Mailing address:
  • Phone: 970-858-3900
  • Fax: 970-858-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number44419
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: