Provider Demographics
NPI:1760544241
Name:MORRIS, LARRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:L
Last Name:MORRIS
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 1:2160 EWING CRAWFIS CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9042
Mailing Address - Country:US
Mailing Address - Phone:937-599-0045
Mailing Address - Fax:937-599-5209
Practice Address - Street 1:2160 EWING CRAWFIS CIR
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9042
Practice Address - Country:US
Practice Address - Phone:937-599-0045
Practice Address - Fax:937-599-5209
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH038166208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282180Medicaid
OH0282180Medicaid