Provider Demographics
NPI:1710210323
Name:MORRISON, KENDRICK OLIVER (MD)
Entity Type:Individual
Prefix:
First Name:KENDRICK
Middle Name:OLIVER
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 QUARTZ DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8382
Mailing Address - Country:US
Mailing Address - Phone:801-527-2425
Mailing Address - Fax:801-527-2425
Practice Address - Street 1:1599 QUARTZ DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8382
Practice Address - Country:US
Practice Address - Phone:801-527-2425
Practice Address - Fax:801-527-2425
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1507561205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology