Provider Demographics
NPI:1154648640
Name:MORRIS, TARGHEE JAMES (MD)
Entity Type:Individual
Prefix:
First Name:TARGHEE
Middle Name:JAMES
Last Name:MORRIS
Suffix:
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 1:415 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1439
Mailing Address - Country:US
Mailing Address - Phone:801-609-4476
Mailing Address - Fax:801-609-4476
Practice Address - Street 1:336 W 100 S
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-5881
Practice Address - Country:US
Practice Address - Phone:801-609-4476
Practice Address - Fax:801-734-3964
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46511390200000X, 208800000X
UT8535063-8905208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program