Provider Demographics
NPI:1235342379
Name:PANTER, MORRIS LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:LEE
Last Name:PANTER
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 1:1401 3RD AVE, WEST, SUITE 108
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35208
Mailing Address - Country:US
Mailing Address - Phone:205-561-0015
Mailing Address - Fax:205-957-6740
Practice Address - Street 1:1401 3RD AVE, WEST, SUITE 108
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35208
Practice Address - Country:US
Practice Address - Phone:205-561-0015
Practice Address - Fax:205-957-6740
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00121090Medicaid
MS350000239Medicare Oscar/Certification
MSU37443Medicare UPIN