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General NPI Number Information
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NPI Number | 1265805568
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Entity Type | Organization
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Legal Business Name | DR. DOUGLAS W. MORRELL
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 606 E 11TH ST
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City | RUSHVILLE
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State | IN
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Zip | 46173-1319
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Country | US
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Telephone | 765-932-2965
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Fax | 765-932-4859
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Provider Business Mailing Address
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Address Line | 606 E 11TH ST
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City | RUSHVILLE
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State | IN
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Zip | 46173-1319
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Country | US
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Telephone | 765-932-2965
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Fax | 765-932-4859
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS W. MORRELL
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Credential | M.D.
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Telephone | 765-932-2965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01024901A
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License Number State | IN
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