Provider Demographics
NPI:1124024849
Name:MORRIS, EUGENE BRANNON III (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:BRANNON
Last Name:MORRIS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 1/2 BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6316
Mailing Address - Country:US
Mailing Address - Phone:706-353-0606
Mailing Address - Fax:706-353-0798
Practice Address - Street 1:1086 1/2 BAXTER ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6316
Practice Address - Country:US
Practice Address - Phone:706-353-0606
Practice Address - Fax:706-353-0798
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38252208000000X
GA639222084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010210712Medicaid
MT0149583Medicaid
IN200520170AMedicaid
ME422400000Medicaid
LA1628883Medicaid
AR158894001Medicaid
TN5440557Medicaid
AL009998455Medicaid
MS03058877Medicaid
TX176786501Medicaid
MO207281007Medicaid
OK200056700AMedicaid
KY64100639Medicaid
AL009998455Medicaid