Provider Demographics
NPI:1508972381
Name:MORRIS, ROBERT J
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1878 VANDERLYN DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4335
Mailing Address - Country:US
Mailing Address - Phone:404-727-0666
Mailing Address - Fax:
Practice Address - Street 1:101 WOODRUFF CIR
Practice Address - Street 2:EMORY UNIVERSITY, DEPARTMENT OF DERMATOLOGY, ROOM 5034
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-727-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034420207ND0900X
NY233885-1207ND0900X
IL207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA22BDGQGMedicare ID - Type Unspecified
GAG01425001Medicare UPIN