Provider Demographics
NPI:1235139833
Name:MORRIS, JED LANE (MD)
Entity Type:Individual
Prefix:
First Name:JED
Middle Name:LANE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4869
Mailing Address - Street 2:DEPARTMENT 235
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4869
Mailing Address - Country:US
Mailing Address - Phone:877-744-1141
Mailing Address - Fax:847-537-4866
Practice Address - Street 1:3401 NORTH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3743
Practice Address - Country:US
Practice Address - Phone:225-387-0851
Practice Address - Fax:225-383-8477
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA03455R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00143410OtherRAILROAD MEDICARE
LA1135780Medicaid
LAE73371Medicare UPIN
LA5L329Medicare PIN