MEDICARE: DR. ROBERT P 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	207N00000X	Dermatology Physician	2150041	NY

General Provider Information

NPI Number	:	1700866217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT P MORRIS MD

Provider Business Mailing Address
First Line	:	45 N FULTON ST
Second Line	:	PO BOX 346
City	:	HOMER
State	:	NY
Zip	:	13077
Country	:	US
Telephone Number	:	607-753-0683
Fax Number	:	607-753-6408

Provider Business Practice Location Address
First Line	:	45 N FULTON ST
Second Line	:
City	:	HOMER
State	:	NY
Zip	:	13077
Country	:	US
Telephone Number	:	607-753-0683
Fax Number	:	607-753-6408

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/08/2007

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