Healthcare Provider Details

I. General information

NPI: 1811948995
Provider Name (Legal Business Name): MARY SACIA MORRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 MIDWEST DR ALLERGY ASSOCIATES OF LA CROSSE, LTD.
ONALASKA WI
54650-6758
US

IV. Provider business mailing address

2727 MIDWEST DR ALLERGY ASSOCIATES OF LA CROSSE, LTD.
ONALASKA WI
54650-6758
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-2027
  • Fax:
Mailing address:
  • Phone: 608-782-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number26435
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: