Provider Demographics
NPI:1609843390
Name:MORRISON OPTOMETRIC ASSOCIATES PA
Entity Type:Organization
Organization Name:MORRISON OPTOMETRIC ASSOCIATES PA
Other - Org Name:VISION SOURCE OF COLBY, GOODLAND, BURLINGTON, ATWOOD & ST FRANCIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHOAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-462-8231
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-0687
Mailing Address - Country:US
Mailing Address - Phone:785-462-8231
Mailing Address - Fax:785-462-2307
Practice Address - Street 1:1275 ROSE AVE STE A
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-1678
Practice Address - Country:US
Practice Address - Phone:719-346-8415
Practice Address - Fax:785-462-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100219880AMedicaid
CO76557758Medicaid
KSCS8632OtherRAILROAD MEDICARE
COCOB4231Medicare PIN
KS0381270003Medicare NSC
KSCS8632OtherRAILROAD MEDICARE
KS100219880AMedicaid
CO76557758Medicaid