Provider Demographics
NPI:1376597534
Name:PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MORHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-448-6008
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:NH
Mailing Address - Zip Code:03750-0350
Mailing Address - Country:US
Mailing Address - Phone:603-448-6008
Mailing Address - Fax:
Practice Address - Street 1:6 S PARK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1326
Practice Address - Country:US
Practice Address - Phone:603-448-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9931207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010196Medicaid
VT0RE4390Medicaid
VT0RE4390Medicaid
NH0002788Medicare PIN