Healthcare Provider Details

I. General information

NPI: 1679101992
Provider Name (Legal Business Name): RYAN J MORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 W COUGAR BLVD STE 704
PROVO UT
84604-3333
US

IV. Provider business mailing address

2401 S 31ST ST # MSAG407Q
TEMPLE TX
76508-0001
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-3242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number7681519
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number14213833-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: