Healthcare Provider Details

I. General information

NPI: 1558668913
Provider Name (Legal Business Name): MATTHEW L MORRIS H.I.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7771 E WASHINGTON ST
INDIANAPOLIS IN
46219-6742
US

IV. Provider business mailing address

7771 E WASHINGTON ST
INDIANAPOLIS IN
46219-6742
US

V. Phone/Fax

Practice location:
  • Phone: 317-375-0979
  • Fax: 317-354-9846
Mailing address:
  • Phone: 317-375-0979
  • Fax: 317-354-9846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number17001336A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: