Provider Demographics
NPI:1508935966
Name:BEEBE, MORRIS WILSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:WILSON
Last Name:BEEBE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1325
Mailing Address - Country:US
Mailing Address - Phone:606-526-8131
Mailing Address - Fax:606-528-8661
Practice Address - Street 1:95 BRYAN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2788
Practice Address - Country:US
Practice Address - Phone:606-523-3021
Practice Address - Fax:606-523-3040
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22810207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64228109Medicaid
KYP01427464OtherRR MEDICARE
KYK103441Medicare PIN
C73806Medicare UPIN
KYP400029105Medicare PIN