Provider Demographics
NPI:1083724553
Name:MORRIS, THOMAS ALPHEUS III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALPHEUS
Last Name:MORRIS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:ALPHEUS
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:51 LIBBY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2949
Mailing Address - Country:US
Mailing Address - Phone:508-587-6060
Mailing Address - Fax:508-588-0678
Practice Address - Street 1:51 LIBBY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2949
Practice Address - Country:US
Practice Address - Phone:508-587-6060
Practice Address - Fax:508-588-0678
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49635207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ02281 MOOtherBLUE SHIELD OF MA
MA110063893/AMedicaid
MA23555PCLOtherHARVARD PILGRIM
MA711364OtherTUFTS HEALTH PLAN
MA23555PCLOtherHARVARD PILGRIM
MA711364OtherTUFTS HEALTH PLAN