Provider Demographics
NPI:1619096476
Name:MONCURE, MORRIS LEE
Entity Type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:LEE
Last Name:MONCURE
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 1:303 E MARION AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39059-2795
Mailing Address - Country:US
Mailing Address - Phone:601-892-7745
Mailing Address - Fax:601-892-7746
Practice Address - Street 1:7360 HIGHWAY 1
Practice Address - Street 2:SUITE 3
Practice Address - City:MANSURA
Practice Address - State:LA
Practice Address - Zip Code:71350-4206
Practice Address - Country:US
Practice Address - Phone:601-832-6024
Practice Address - Fax:601-892-7746
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies