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General NPI Number Information
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NPI Number | 1780641126
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Entity Type | Individual
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Provider Name | SUSAN MORRIS MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 1005 BELLEFONTAINE AVE STE 360
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City | LIMA
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State | OH
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Zip | 45804-2887
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Country | US
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Telephone | 419-998-8205
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Fax | 419-998-8220
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Provider Business Mailing Address
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Address Line | 2901 AMANDA LAKES DR
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City | LIMA
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State | OH
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Zip | 45805-4463
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Country | US
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Telephone | 419-230-4204
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35071139
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License Number State | OH
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