Provider Demographics
NPI:1114937935
Name:MORRIS, PHILLIP J (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2644
Mailing Address - Country:US
Mailing Address - Phone:502-456-1771
Mailing Address - Fax:502-451-4484
Practice Address - Street 1:2815 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2644
Practice Address - Country:US
Practice Address - Phone:502-456-1771
Practice Address - Fax:502-451-4484
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85044071Medicaid
KY1700301Medicare ID - Type Unspecified
KY85044071Medicaid