Healthcare Provider Details

I. General information

NPI: 1407055700
Provider Name (Legal Business Name): JOHN CHARLES MORRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST BARRETT CENTER
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

2830 VICTORY PARKWAY CENTRAL CREDENTIALING
CINCINNATI OH
45206-1785
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-6928
  • Fax: 513-584-4281
Mailing address:
  • Phone: 513-245-3669
  • Fax: 513-475-7259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number156395
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35-096313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: