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General NPI Number Information
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NPI Number | 1366008682
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Entity Type | Organization
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Legal Business Name | CUC-LLC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 619 N PROVIDENCE RD
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City | COLUMBIA
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State | MO
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Zip | 65203-4355
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Country | US
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Telephone | 573-234-1070
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Fax | 573-818-1342
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Provider Business Mailing Address
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Address Line | 619 N PROVIDENCE RD
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City | COLUMBIA
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State | MO
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Zip | 65203-4355
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Country | US
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Telephone | 573-234-1070
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Fax | 573-818-1342
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN WAYNE MORRIS
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Credential | MD
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Telephone | 573-234-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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