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General NPI Number Information
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NPI Number | 1174998041
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Entity Type | Organization
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Legal Business Name | WALTER S MORRIS III MD PLLC
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 390 SW BROAD ST UNIT A
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5407
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Country | US
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Telephone | 910-639-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 390 SW BROAD ST UNIT A
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | DR. WALTER SMITH MORRIS III
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Credential | MD
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Telephone | 910-639-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 9300545
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License Number State | NC
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