Provider Demographics
NPI:1508858713
Name:MORRISON, SCOTT F (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:F
Last Name:MORRISON
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 1:310 N 7 HILLS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-4111
Mailing Address - Country:US
Mailing Address - Phone:618-624-6181
Mailing Address - Fax:618-624-7172
Practice Address - Street 1:310 N 7 HILLS RD STE 220
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-4111
Practice Address - Country:US
Practice Address - Phone:618-624-6181
Practice Address - Fax:618-624-7172
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-109861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109861Medicaid
ILK02624Medicare ID - Type Unspecified
IL036109861Medicaid
ILIL3374046Medicare PIN