Provider Demographics
NPI:1619998267
Name:MORRIS, OLIVIA E (DO)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:E
Last Name:MORRIS
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 1:4101 INDIAN SCHOOL RD NE STE 110
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3991
Mailing Address - Country:US
Mailing Address - Phone:505-727-4430
Mailing Address - Fax:
Practice Address - Street 1:10511 GOLF COURSE RD NW STE 204
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5917
Practice Address - Country:US
Practice Address - Phone:505-727-4430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4121207X00000X, 207XS0114X, 207XX0005X
TXK1574207XX0005X
NMA-1818-14207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5550830009OtherMEDICARE NSC AZ NORTH
NM16587090Medicaid
AZ5550830001OtherMEDICARE NSC SCW
AZZ226497OtherMEDICARE PTAN
AZ5550830004OtherMEDICARE NSC PV
AZ5550830003OtherMEDICARE NSC PEORIA
AZ5550830007OtherMEDICARE NSC DV
AZ5550830008OtherMEDICARE NSC SWV
AZ5550830006OtherMEDICARE NSC ANTHEM
AZ882515Medicaid
AZ5550830010OtherMEDICARE NSC GILBERT