Healthcare Provider Details

I. General information

NPI: 1366008682
Provider Name (Legal Business Name): CUC-LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N PROVIDENCE RD
COLUMBIA MO
65203-4355
US

IV. Provider business mailing address

619 N PROVIDENCE RD
COLUMBIA MO
65203-4355
US

V. Phone/Fax

Practice location:
  • Phone: 573-234-1070
  • Fax: 573-818-1342
Mailing address:
  • Phone: 573-234-1070
  • Fax: 573-818-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN WAYNE MORRIS
Title or Position: OWNER
Credential: MD
Phone: 573-234-1070