Provider Demographics
NPI:1619947991
Name:MORRIS, DELL C (OD)
Entity Type:Individual
Prefix:DR
First Name:DELL
Middle Name:C
Last Name:MORRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1010
Mailing Address - Country:US
Mailing Address - Phone:801-374-1818
Mailing Address - Fax:801-374-1826
Practice Address - Street 1:1735 N STATE ST
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1010
Practice Address - Country:US
Practice Address - Phone:801-374-1818
Practice Address - Fax:801-379-2959
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3270569934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT64757OtherPEHP
UT208819OtherALTIUS
UT87028357684604A001OtherTRICARE
UT107002178102OtherSELECT HEALTH
UT410045092OtherUNITED HEALTHCARE
UT297186OtherDMBA
UT870283576MO1OtherEMIA
UT410045092OtherUNITED HEALTHCARE
UT64757OtherPEHP