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NPI Code Detail

MEDICARE: BRENT S MORRIS M.D.

MEDICARE: BRENT S MORRIS M.D.
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
1208000000XPediatrics Physician045896GA
2208000000XPediatrics PhysicianMD0000012571TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063400695
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT S MORRIS M.D.
Provider Business Mailing Address
First Line : 3927 WINDTREE DR
Second Line :
City : SIGNAL MTN
State : TN
Zip : 37377-1279
Country : US
Telephone Number : 423-517-0544
Fax Number : 423-842-5353
Provider Business Practice Location Address
First Line : 9527 W RIDGE TRAIL RD
Second Line :
City : SODDY DAISY
State : TN
Zip : 37379-4018
Country : US
Telephone Number : 423-842-3031
Fax Number : 423-842-5353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 03/31/2009

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