=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013090174
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN E MORRISON JR. M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2006
-----------------------------------------------------
Last Update Date | 02/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1035 TEMPLE AVE N
-----------------------------------------------------
City | FAYETTE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35555-1923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-932-3879
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 70
-----------------------------------------------------
City | FAYETTE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35555-0070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 13240
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 10199
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------