Provider Demographics
NPI:1477667269
Name:MORRIS, JOSEPH FREDRICK (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FREDRICK
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 KEENE RD STE 102
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-7600
Practice Address - Country:US
Practice Address - Phone:859-887-6752
Practice Address - Fax:859-887-6879
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64310170Medicaid
OH0149397Medicaid
KYG12701Medicare UPIN
KY1597701Medicare PIN
KY64310170Medicaid
KY1597701Medicare PIN
KY0100704OtherUNITED HEALTHCARE
KY64310170Medicaid