=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376597534
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2006
-----------------------------------------------------
Last Update Date | 05/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 S PARK ST
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03766-1326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-448-6008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 350
-----------------------------------------------------
City | ETNA
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03750-0350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-448-6008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. PATRICK JAMES MORHUN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 603-448-6008
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 9931
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------