Healthcare Provider Details

I. General information

NPI: 1114925682
Provider Name (Legal Business Name): ROBERT T. MORRISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 6250
DAYTON OH
45409-2939
US

IV. Provider business mailing address

30 E APPLE ST SUITE 6250
DAYTON OH
45409-2939
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8394
  • Fax: 937-208-8394
Mailing address:
  • Phone: 937-208-8394
  • Fax: 937-208-8388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.066817
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: