Provider Demographics
NPI:1497759427
Name:MORRIS, THOMAS ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ARNOLD
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEORGE THOMAS
Other - Middle Name:ARNOLD
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:25 BROOKSIDE PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1971
Mailing Address - Country:US
Mailing Address - Phone:919-309-9993
Mailing Address - Fax:
Practice Address - Street 1:25 BROOKSIDE PL
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-1971
Practice Address - Country:US
Practice Address - Phone:919-309-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
03605590291OtherEDUCATION NUMBER
NCD32992Medicare UPIN