Healthcare Provider Details

I. General information

NPI: 1427493709
Provider Name (Legal Business Name): SENIOR MEDICAL SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HENDERSON DR STE 430
CARTERSVILLE GA
30120-3760
US

IV. Provider business mailing address

650 HENDERSON DR STE 430
CARTERSVILLE GA
30120-3760
US

V. Phone/Fax

Practice location:
  • Phone: 678-310-3531
  • Fax: 770-684-0903
Mailing address:
  • Phone: 678-310-3531
  • Fax: 770-684-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21115
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number23242
License Number StateGA

VIII. Authorized Official

Name: DR. NICHOLAS LLOYD MORROW
Title or Position: PHYSICIAN
Credential: MD
Phone: 678-848-0722