Provider Demographics
NPI:1487657284
Name:MORRIS, TERRY V (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:V
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 NW MOCK AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2507
Mailing Address - Country:US
Mailing Address - Phone:816-641-8650
Mailing Address - Fax:816-641-8651
Practice Address - Street 1:206 NW MOCK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2507
Practice Address - Country:US
Practice Address - Phone:816-461-8650
Practice Address - Fax:816-461-8651
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR6994174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO07999015OtherBCBS
MO160011389OtherMEDICARE RR
MOC51536Medicare UPIN
MO07999015OtherBCBS