Healthcare Provider Details

I. General information

NPI: 1679582878
Provider Name (Legal Business Name): RICK J MORRIS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12265 WEST BAYAUD AVE SUITE 120
LAKEWOOD CO
80228-2116
US

IV. Provider business mailing address

12265 WEST BAYAUD AVE SUITE 120
LAKEWOOD CO
80228-2116
US

V. Phone/Fax

Practice location:
  • Phone: 720-709-7334
  • Fax: 720-709-7336
Mailing address:
  • Phone: 720-709-7334
  • Fax: 720-709-7336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberOPT0003171
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: