MEDICARE: DENIS MORIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	024466	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	113959	OTHER		RURAL HEALTH MEDICARE PIN
2	DD7682	OTHER		RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003020967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENIS MORIN

Provider Business Mailing Address
First Line	:	30 BUCHANAN BYP
Second Line	:
City	:	BUCHANAN
State	:	GA
Zip	:	30113-4924
Country	:	US
Telephone Number	:	770-646-8281
Fax Number	:	770-646-3579

Provider Business Practice Location Address
First Line	:	30 BUCHANAN BYP
Second Line	:
City	:	BUCHANAN
State	:	GA
Zip	:	30113-4924
Country	:	US
Telephone Number	:	770-646-8281
Fax Number	:	770-646-3579

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MELANIE D COGGINS
Credential	:
Telephone Number	:	770-646-8281

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/28/2010

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Directions to “DENIS MORIN ” Practice Location

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