Provider Demographics
NPI:1366451007
Name:MORRIS, CHRISTOPHER WADE (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WADE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 E ARBOR AVE
Mailing Address - Street 2:STE 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-6103
Mailing Address - Country:US
Mailing Address - Phone:480-219-1010
Mailing Address - Fax:480-219-1771
Practice Address - Street 1:6116 E ARBOR AVE STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-6103
Practice Address - Country:US
Practice Address - Phone:480-219-1010
Practice Address - Fax:480-219-1771
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2846363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ862111Medicaid
AZ862111Medicaid
AZ862111Medicaid
AZ79608Medicare PIN