Provider Demographics
NPI:1790098218
Name:MORRISON, NORRIS SR (DPM)
Entity Type:Individual
Prefix:DR
First Name:NORRIS
Middle Name:
Last Name:MORRISON
Suffix:SR
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 1:18225 OUTER HWY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2203
Mailing Address - Country:US
Mailing Address - Phone:760-242-4199
Mailing Address - Fax:760-242-3814
Practice Address - Street 1:18225 OUTER HWY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2203
Practice Address - Country:US
Practice Address - Phone:760-242-4199
Practice Address - Fax:760-242-4199
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116022798213E00000X
FLPO3754213E00000X
CAE5319213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE5319OtherMEDICAL LICENSE