1528024734 NPI number — NANCY V MORRIS MD PLLC

Table of content: (NPI 1528024734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528024734 NPI number — NANCY V MORRIS MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANCY V MORRIS MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAUREL MEDICAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528024734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 CITY HILL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40741-3038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-877-2050
Provider Business Mailing Address Fax Number:
606-877-2080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
175 CITY HILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40741-3038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-877-2050
Provider Business Practice Location Address Fax Number:
606-877-2080
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
V
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
606-877-2050

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  38962 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 32043 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363A00000X , with the licence number: PA430 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 5204P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000479659 . This is a "BCBS OF KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100025400 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com