Healthcare Provider Details

I. General information

NPI: 1861611501
Provider Name (Legal Business Name): JAMES L MORRISON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989 JAMES ST
SYRACUSE NY
13203-2610
US

IV. Provider business mailing address

989 JAMES ST
SYRACUSE NY
13203-2610
US

V. Phone/Fax

Practice location:
  • Phone: 315-474-6915
  • Fax: 315-424-8525
Mailing address:
  • Phone: 315-474-6915
  • Fax: 315-424-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number3429
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: