Provider Demographics
NPI:1558302604
Name:MORRISON, JEANETTE M (DO)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:M
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-0525
Mailing Address - Country:US
Mailing Address - Phone:610-933-8000
Mailing Address - Fax:610-917-1326
Practice Address - Street 1:826 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4459
Practice Address - Country:US
Practice Address - Phone:610-933-8484
Practice Address - Fax:610-917-1326
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006890L207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00180738/DC5012OtherRRM
PA10932815OtherCAQH ID#
PA0161121705OtherAMERICHOICE (UHC MA PLAN)
PA0510549000OtherIBC - PC/KHPE
PA2075271OtherCIGNA HMO/PPO
PA9089035OtherPHCS
PA2538354OtherAETNA HMO
PA0016112170010Medicaid
PA16523-OS006890LOtherHEALTH PARTNERS
PA0510549000OtherAMERIHEALTH/INTERCOUNTY
PA2123929OtherALLIANCE/OPT CHC (MAMSI)
PAP2651836OtherOXFORD
PA1163092OtherKEYSTONE MERCY
PA4269395OtherAETNA PPO
PA677032OtherHIGHMARK BLUE SHIELD
PA2123929OtherALLIANCE/OPT CHC (MAMSI)
PA677032GFHMedicare ID - Type UnspecifiedHGSA