Provider Demographics
NPI:1083926414
Name:MORRIS, STEVEN R
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 BIRCHWOOD COURT
Mailing Address - Street 2:SUITE S
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2930
Mailing Address - Country:US
Mailing Address - Phone:515-471-9720
Mailing Address - Fax:515-471-9725
Practice Address - Street 1:840 E UNIVERSITY AVENUE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2304
Practice Address - Country:US
Practice Address - Phone:515-265-4211
Practice Address - Fax:515-309-5993
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-8933207Q00000X
IA4218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP01065816OtherRR MEDICARE
IA1083926414Medicaid
IA1083926414Medicaid