Provider Demographics
NPI:1447233044
Name:MORRISON, KIRK D (DC, DABCO)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:D
Last Name:MORRISON
Suffix:
Gender:M
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E LEWIS AND CLARK PKWY
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-1723
Mailing Address - Country:US
Mailing Address - Phone:812-941-9930
Mailing Address - Fax:812-941-9940
Practice Address - Street 1:209 E LEWIS AND CLARK PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1723
Practice Address - Country:US
Practice Address - Phone:812-941-9930
Practice Address - Fax:812-941-9940
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001243A111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN350034998OtherRRMR
IN351955373100OtherCARESOURCE
IN214844100OtherACS
IN000000042675OtherANTHEM BC/BS
IN100076550AMedicaid
IN214844100OtherACS
INU29010Medicare UPIN