Provider Demographics
NPI:1710405675
Name:MORRIS, OWEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 N 52ND ST STE S-3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4736
Mailing Address - Country:US
Mailing Address - Phone:267-930-4858
Mailing Address - Fax:267-299-6270
Practice Address - Street 1:1575 N 52ND ST STE S-3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4736
Practice Address - Country:US
Practice Address - Phone:267-930-4858
Practice Address - Fax:267-299-6270
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00354500213EP1101X
PASC007232213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine