Healthcare Provider Details

I. General information

NPI: 1821169145
Provider Name (Legal Business Name): JOANNA MORRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 DAWSON COMMONS CIR STE. 320
DAWSONVILLE GA
30534-6268
US

IV. Provider business mailing address

300 DAWSON COMMONS CIR STE. 320
DAWSONVILLE GA
30534-6268
US

V. Phone/Fax

Practice location:
  • Phone: 706-216-2770
  • Fax: 706-216-2944
Mailing address:
  • Phone: 706-216-2770
  • Fax: 706-216-2770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number058081
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: