Healthcare Provider Details

I. General information

NPI: 1578770475
Provider Name (Legal Business Name): ROBERT J MORRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33089 GROESBECK HWY
FRASER MI
48026-1501
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 586-296-2800
  • Fax:
Mailing address:
  • Phone: 972-364-8084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301055557
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: