=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013205970
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL JASON MORRIS D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2011
-----------------------------------------------------
Last Update Date | 03/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1446 JONES DAIRY RD STE 100
-----------------------------------------------------
City | JASPER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-221-4916
-----------------------------------------------------
Fax | 205-221-4939
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1446 JONES DAIRY RD STE 100
-----------------------------------------------------
City | JASPER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35501-6117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-221-4916
-----------------------------------------------------
Fax | 205-221-4939
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0005X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
-----------------------------------------------------
License Number | 75464
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207XX0005X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
-----------------------------------------------------
License Number | DO.1591
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------