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General NPI Number Information
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NPI Number | 1205487170
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Entity Type | Individual
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Provider Name | KENNETH D MORRISON PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 225 EXECUTIVE PARK
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City | LOUISVILLE
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State | KY
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Zip | 40207-4202
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Country | US
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Telephone | 502-855-7200
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Fax | 502-855-7201
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Provider Business Mailing Address
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Address Line | 223 EXECUTIVE PARK
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City | LOUISVILLE
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State | KY
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Zip | 40207-4202
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Country | US
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Telephone | 502-907-0356
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Fax | 502-919-9780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TC862
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License Number State | KY
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