Provider Demographics
NPI:1235127762
Name:MORRISON, RICHARD CLARKE (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CLARKE
Last Name:MORRISON
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 1:1604 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3125
Mailing Address - Country:US
Mailing Address - Phone:423-648-2395
Mailing Address - Fax:423-648-7542
Practice Address - Street 1:6013 SHALLOWFORD RD STE 117
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1612
Practice Address - Country:US
Practice Address - Phone:423-498-3570
Practice Address - Fax:423-498-3571
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA019972208G00000X
TN11550208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3008748Medicaid
A97318Medicare UPIN
TN3008749Medicare PIN
GAGRP3449Medicare PIN