Provider Demographics
NPI:1114180809
Name:LOUIS T MORRISON MD PA
Entity Type:Organization
Organization Name:LOUIS T MORRISON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS T
Authorized Official - Middle Name:T
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:954-581-0122
Mailing Address - Street 1:910 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4523
Mailing Address - Country:US
Mailing Address - Phone:954-583-0122
Mailing Address - Fax:954-583-9285
Practice Address - Street 1:910 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2813
Practice Address - Country:US
Practice Address - Phone:954-583-0122
Practice Address - Fax:954-583-9285
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOUIS T MORRISON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-03
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371447100Medicaid
FLF44568Medicare UPIN
FL371447100Medicaid