Provider Demographics
NPI:1760457881
Name:MORRISON, JEFFREY B (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:MORRISON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701
Mailing Address - Country:US
Mailing Address - Phone:785-462-8231
Mailing Address - Fax:785-462-2307
Practice Address - Street 1:1005 S RANGE AVE
Practice Address - Street 2:STE 100
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3537
Practice Address - Country:US
Practice Address - Phone:785-462-8231
Practice Address - Fax:785-462-2307
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14063152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100219870BMedicaid
CO2687OtherSTATE LICENSE
KS410029737OtherRAILROAD MEDICARE
KS1406-3OtherSTATE LICENSE
KS410029737OtherRAILROAD MEDICARE
U43889Medicare UPIN
KS0381270001Medicare NSC