Provider Demographics
NPI:1417351479
Name:MORRIS, DAVID JOSEPH
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D INTERN
Mailing Address - Street 1:28138 N TATUM BLVD
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-6303
Mailing Address - Country:US
Mailing Address - Phone:480-585-6097
Mailing Address - Fax:480-585-6312
Practice Address - Street 1:28138 NORTH TATUM BLVD
Practice Address - Street 2:
Practice Address - City:CAVECREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331
Practice Address - Country:US
Practice Address - Phone:480-585-6097
Practice Address - Fax:480-585-6312
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZI010489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist