MEDICARE: RAY MORRIS III MD

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	207Q00000X	Family Medicine Physician	932651751205	UT
2	207Q00000X	Family Medicine Physician	H1705	TX
3	207Q00000X	Family Medicine Physician	168063	NY

General Provider Information

NPI Number	:	1023171014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAY MORRIS III MD

Provider Business Mailing Address
First Line	:	3465 SO 4155 W SUITE #2
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2082
Country	:	US
Telephone Number	:	801-963-7636
Fax Number	:	801-963-8130

Provider Business Practice Location Address
First Line	:	3465 SO 4155 W SUITE #2
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2082
Country	:	US
Telephone Number	:	801-963-7636
Fax Number	:	801-963-8130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/09/2010

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