MEDICARE: MATTHEW L MORRIS H.I.S.

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	237700000X	Hearing Instrument Specialist	17001336A	IN

General Provider Information

NPI Number	:	1558668913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW L MORRIS H.I.S.

Provider Business Mailing Address
First Line	:	7771 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6742
Country	:	US
Telephone Number	:	317-375-0979
Fax Number	:	317-354-9846

Provider Business Practice Location Address
First Line	:	7771 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6742
Country	:	US
Telephone Number	:	317-375-0979
Fax Number	:	317-354-9846

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

Provider Enumeration Date	:	02/22/2011
Last Update Date	:	02/22/2011

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