=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770823098
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMERGENCY AND CRITICAL CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2013
-----------------------------------------------------
Last Update Date | 02/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8965 HIGHWAY 79
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71033-2721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-938-5898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8965 HIGHWAY 79
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71033-2721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-938-5898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RICHARD LOUIS MORRISON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 318-938-5898
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | MD202138
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | MD202138
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------