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General NPI Number Information
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NPI Number | 1801497011
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Entity Type | Individual
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Provider Name | LYMAN LESTER MORRIS III PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 3313 W STATE ROAD 45
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City | BLOOMINGTON
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State | IN
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Zip | 47403-5107
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Country | US
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Telephone | 812-335-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 3947 LITTLE HURRICANE RD
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City | MARTINSVILLE
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State | IN
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Zip | 46151
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Country | US
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Telephone | 502-593-0833
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26024128A
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License Number State | IN
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