MEDICARE: MR. WILLIAM GAINEY MORROZOFF JR. FNP-BC

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	363LF0000X	Family Nurse Practitioner	201042	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2599170D	OTHER	NC	MEDICARE PTAN

General Provider Information

NPI Number	:	1437156767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM GAINEY MORROZOFF JR. FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-0128
Country	:	US
Telephone Number	:	910-858-3913
Fax Number	:	910-858-3610

Provider Business Practice Location Address
First Line	:	15 W THIRD ST
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-0128
Country	:	US
Telephone Number	:	910-858-3913
Fax Number	:	910-858-3610

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	04/01/2011

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