Provider Demographics
NPI:1639262165
Name:MORRIS, MICHAEL PERRY (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PERRY
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 E NAVAJO AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-7769
Mailing Address - Country:US
Mailing Address - Phone:480-671-4780
Mailing Address - Fax:480-357-3698
Practice Address - Street 1:11518 E APACHE TRL
Practice Address - Street 2:119
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3551
Practice Address - Country:US
Practice Address - Phone:480-357-3695
Practice Address - Fax:480-357-3698
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20-0168358OtherTAX ID NO.
AZ870897OtherAHCCCS
AZP00138300OtherRAILROAD MEDICARE
AZ624220OtherACN
AZAZ0942540OtherBLUE CROSS BLUE SHIELD AZ
AZP00138300OtherRAILROAD MEDICARE
AZZ82146Medicare PIN