Provider Demographics
NPI:1326380163
Name:MORRIS, KEVIN TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:TODD
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 1:8045 ROANE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8333
Mailing Address - Country:US
Mailing Address - Phone:865-316-3375
Mailing Address - Fax:
Practice Address - Street 1:8045 ROANE MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8333
Practice Address - Country:US
Practice Address - Phone:865-316-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54618208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2335162Medicaid