=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194857300
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | G G MORRISON LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2007
-----------------------------------------------------
Last Update Date | 11/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 RED MAPLE TRL
-----------------------------------------------------
City | PETAL
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39465-2678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-310-6455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 102 RED MAPLE TRL
-----------------------------------------------------
City | PETAL
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39465-2678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-310-6455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GERALYNN G. MORRISON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 601-310-6455
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------