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General NPI Number Information
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NPI Number | 1609885219
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Entity Type | Individual
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Provider Name | KENNETH RUSSELL MORSE MD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 78 RIDGEWOOD DR
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City | BANGOR
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State | ME
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Zip | 04401-2652
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Country | US
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Telephone | 207-947-8381
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Fax | 207-947-5708
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Provider Business Mailing Address
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Address Line | 78 RIDGEWOOD DR
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City | BANGOR
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State | ME
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Zip | 04401-2652
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Country | US
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Telephone | 207-947-8381
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Fax | 207-947-5708
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 018059
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License Number State | ME
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