Healthcare Provider Details

I. General information

NPI: 1477668853
Provider Name (Legal Business Name): GREGORY BRETT MORRIS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 802
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1380 LUSITANA ST SUITE 608
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-532-3338
  • Fax: 808-525-6868
Mailing address:
  • Phone: 808-536-2261
  • Fax: 808-538-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO150
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: