Healthcare Provider Details

I. General information

NPI: 1801865944
Provider Name (Legal Business Name): THOMAS R MORRIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 ELIDA AVE
DELPHOS OH
45833-1785
US

IV. Provider business mailing address

933 ELIDA AVE
DELPHOS OH
45833-1785
US

V. Phone/Fax

Practice location:
  • Phone: 419-692-9050
  • Fax: 419-692-9060
Mailing address:
  • Phone: 419-692-9050
  • Fax: 419-692-9060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number948
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0495334
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: