Healthcare Provider Details

I. General information

NPI: 1558547307
Provider Name (Legal Business Name): SUSAN HENDERSON MORRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-8000
  • Fax:
Mailing address:
  • Phone: 865-541-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number63510
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number63510
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: