Provider Demographics
NPI:1649230269
Name:MORRIS, KATHLEEN CLAIRE (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CLAIRE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1818
Mailing Address - Country:US
Mailing Address - Phone:207-206-7270
Mailing Address - Fax:207-206-7268
Practice Address - Street 1:462 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1818
Practice Address - Country:US
Practice Address - Phone:207-206-7270
Practice Address - Fax:207-206-7268
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012728207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400170161OtherMEDICARE PTAN
ME26442099Medicaid
E28426Medicare UPIN