MEDICARE: DR. KENNETH A MORRIS M.D., PH.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
1	207R00000X	Internal Medicine Physician	125.067875	IL
2	2084N0400X	Neurology Physician	61147	MN
3	2084N0400X	Neurology Physician	12949A	WY
4	2084N0400X	Neurology Physician	DR.0064226	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1770967408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH A MORRIS M.D., PH.D.

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 200
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9075
Country	:	US
Telephone Number	:	970-667-7664
Fax Number	:	970-622-9843

Provider Business Practice Location Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 200
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9075
Country	:	US
Telephone Number	:	970-667-7664
Fax Number	:	970-622-9843

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

Provider Enumeration Date	:	07/13/2015
Last Update Date	:	08/18/2020

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