Healthcare Provider Details

I. General information

NPI: 1316967565
Provider Name (Legal Business Name): DOUGLAS BRITTON MORRIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 12TH AVE NW SUITE E
ARDMORE OK
73401-1227
US

IV. Provider business mailing address

4401 W MEMORIAL RD SUITE 140
OKLAHOMA CITY OK
73134-1785
US

V. Phone/Fax

Practice location:
  • Phone: 580-223-3216
  • Fax: 580-223-4184
Mailing address:
  • Phone: 405-752-3162
  • Fax: 405-936-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number4263
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: