Provider Demographics
NPI:1043273980
Name:MORRISON, ROBERT D (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:MORRISON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 E WINDMILL LN
Mailing Address - Street 2:STE 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2066
Mailing Address - Country:US
Mailing Address - Phone:702-731-2233
Mailing Address - Fax:702-450-6116
Practice Address - Street 1:2055 E WINDMILL LN
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2066
Practice Address - Country:US
Practice Address - Phone:702-731-2233
Practice Address - Fax:702-450-6116
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV0118152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVT67309Medicare UPIN
NVEA412ZMedicare PIN