MEDICARE: DR. TERRY V. MORRIS 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	174400000X	Specialist	MDR6994	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	160011389	OTHER	MO	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07999015	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1487657284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY V. MORRIS MD

Provider Business Mailing Address
First Line	:	206 NW MOCK AVE
Second Line	:	STE 200
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2507
Country	:	US
Telephone Number	:	816-641-8650
Fax Number	:	816-641-8651

Provider Business Practice Location Address
First Line	:	206 NW MOCK AVE
Second Line	:	SUITE 200
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2507
Country	:	US
Telephone Number	:	816-461-8650
Fax Number	:	816-461-8651

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	02/07/2017

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