Provider Demographics
NPI:1033231998
Name:KEN R. MORRIS M.D. P.A.
Entity Type:Organization
Organization Name:KEN R. MORRIS M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:601-825-6181
Mailing Address - Street 1:348 CROSSGATES BLVD
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042
Mailing Address - Country:US
Mailing Address - Phone:601-825-6181
Mailing Address - Fax:601-825-2228
Practice Address - Street 1:348 CROSSGATES BLVD
Practice Address - Street 2:SUITE 1300
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-825-6181
Practice Address - Fax:601-825-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS=========OtherBENMARK
MS=========OtherPHCS
MS=========OtherFOX EVERETT
MS=========OtherFOX-EVERETT
MS=========OtherAMERICAN LIFECARE
MS=========OtherCREATIVE MEDICAL NETWORK
MS=========OtherADVANTRA
MS=========OtherAETNA
MS=========OtherASSURANT HEALTH
MS=========OtherFIRST CHOICE
MS=========OtherCIGNA
MS=========OtherGROUP ADMINISTRATORS LTD
MS=========OtherBLUE CROSS BLUE SHIELD
MS=========OtherINSURANCE CENTER
MS=========OtherSTATE OF MS.
MS=========OtherCOVENTRY
MS=========OtherHUMANA
MS=========OtherDEFINITY
MS=========OtherGPA
MS=========OtherDEFINITY