Provider Demographics
NPI:1447220272
Name:MORRIS, KENNETH A (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-6000
Mailing Address - Country:US
Mailing Address - Phone:215-757-1603
Mailing Address - Fax:215-752-1060
Practice Address - Street 1:2373 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6000
Practice Address - Country:US
Practice Address - Phone:215-752-1810
Practice Address - Fax:215-752-1060
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003316L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014926170004Medicaid
PAD98723Medicare UPIN
PA150407Medicare ID - Type UnspecifiedMEDICARE